The association among psychological factors, pain severity and quality of life in people living beyond adolescent and young adult cancer: a systematic review and meta-analysis

Abstract

Purpose This systematic review and meta-analysis examined associations among psychological factors, pain severity, and quality of life (QoL) in people living beyond adolescent and young adult (AYA) cancer. Methods Four databases were searched from inception till November 16th, 2024. This review was registered on the International Prospective Register of Systematic Reviews database (PROSPERO) (No. CRD42024613478). Meta-analysis estimated effect sizes as Pearson correlation coefficients (r) by using a random-effects model. Certainty of evidence was assessed using the GRADE approach. Results Seventeen articles (13,446 participants) were included. A multilevel meta-analysis of 12 studies (11,962 participants) found that adverse psychological factors may be associated with poorer QoL overall (r = - 0.31; 95% CI: - 0.40 to - 0.22, very low certainty). Adverse psychological factors including worse perceived vulnerability, mental health, anger, cancer-related impact, life satisfaction, body image, depressive symptoms, anxiety, and distress may be associated with overall poorer QoL. Both worse psychological well-being and worse body image may have associations with worse global QoL. Worse mental health, cancer-related impact, life satisfaction, anger, depressive symptoms, anxiety, body image, and psychological well-being may be associated with poorer social functioning. Worse mental health, anger, and body image may be associated with poorer physical functioning. Worse body image and distress may be related to poorer emotional functioning. Worse anger, depressive symptoms, and body image may be associated with worse pain interference. Worse body image may also be associated with poorer role and cognitive functioning. Evidence was insufficient to pool results on pain severity. Conclusion Adverse psychological factors are associated with poorer overall QoL and QoL dimensions in people living beyond AYA cancer. AYA-tailored therapies can be developed based on these findings to enhance healthcare for this unique group of oncology patients. More research is needed to clarify the association among specific psychological factors, pain severity, and multidimensional aspects of QoL.