Psychosocial factors associated with quality of life in cancer survivors: umbrella review
Viktorya Voskanyan, Chiara Marzorati, Diana Sala, Roberto Grasso, Ricardo Pietrobon, Iris van der Heide, Merel Engelaar, Nanne Bos, Augusto Caraceni, Norbert Couspel, Montse Ferrer, Mogens Grøenvold, Stein Kaasa, Claudio Lombardo, Aude Sirven, Hugo Vachon, Galina Velikova, Cinzia Brunelli, Giovanni Apolone, Gabriella Pravettoni
Abstract
Cancer is a severe disease affecting millions of people worldwide (19.3 million new cases in 2020) (Sung et al. 2021 ). It has one of the highest mortality rates (Sung et al. 2021 ). However, due to advances in early cancer screening, detection, and treatment, the number of cancer survivors is rapidly increasing. Cancer survivorship has been defined in several ways, leading to different definitions (Marzorati et al. 2017 ). In one of the first definitions survivorship was described as a process consisting of 3 phases, acute survival phase, extended survival phase, and permanent survivorship (Mullan 1985 ). Later survivorship trajectories were expanded to 4 stages by adding the transitional survival phase. The “acute survival phase” starts with the diagnosis, the “transitional survival phase” is characterized by the end of treatment and the time when survivors are distancing from the medical team, the “extended survival phase” involves survivors in remission or with no evidence of disease, and the “permanent survivorship phase” begins when survivors are cancer free, but still experiencing long-term health and psychological issues (Vaz-Luis et al. 2022 ). However, despite the treatment and recovery, survivors still face numerous challenges, as cancer may leave a great impact on many aspects of survivors’ lives (Harrington et al. 2010 ). More specifically, cancer survivors face physical dysfunctions, psychological and social problems, that lead to an overall decrease in well-being and quality of life (QoL) (Ligt et al. 2019 ). The World Health Organization (WHO) defines QoL as “an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards, and concerns” (“The World Health Organization quality of life assessment (WHOQOL): Position paper from the World Health Organization” 1995 ). However, QoL is a complex and multifaceted concept and is defined and measured differently depending on a number of circumstances. Yet, many scientists measuring QoL follow a policy of incorporating physical function, mental status, and the ability to engage in normative social interactions (Spitzer 1987 ; Post 2014 ).