Effectiveness of cognitive behavioral therapy in improving functional health in cancer survivors: A systematic review and meta-analysis

Abstract

Background: Cancer survivors suffer from health deficits caused by their disease and treatment. This study conducted a systematic review and meta-analysis on how, and to what extent, cognitive-behavioral therapy (CBT) impacts functional health outcomes in cancer survivors.

Methods: We searched 7 electronic databases, 91 published review articles, and 4 professional websites for eligible randomized and non-randomized controlled trials focusing on cancer survivors.

Results: We included 95 studies published between 1986 and 2021. Risk of bias across studies was low overall. We identified an overall statistically significant treatment effect size across functional health categories, d = 0.391, p < 0.001, and significant moderators associated with CBT's treatment effect, i.e., treatment phase and type of comparison.

Conclusions: CBT was effective at improving functional health outcomes of cancer survivors, regardless of therapy delivery modality or number of cancer diagnoses patients had, but not for newly diagnosed patients or those currently benefiting from an active comparator intervention.

Keywords: Cancer; Cognitive behavioral therapy; Fatigue; Functional health; Insomnia; Survivorship; Systematic review and meta-analysis.