Happy thus survivor? A systematic review and meta-analysis on the association between cancer survival and positive states, emotions, and traits.
Level 3 - non-randomized controlled study
Systematic review of observational longitudinal prognostic studies
PubMed 37798951 · doi:10.1002/pon.6224
What was done
A pre-registered systematic review and meta-analysis searched four databases (PubMed, PsycINFO, Embase, Cochrane Library) for longitudinal studies examining the link between positive psychological states, emotions, and traits and survival or mortality in cancer patients. Two reviewers independently selected studies, extracted data, and evaluated risk of bias using the Quality in Prognosis Studies tool.
What was found
Twenty-four longitudinal studies comprising 822,789 patients were analyzed. Positive affect was associated with significantly longer survival (Hazard Ratio [HR] = 0.91; 95% CI [0.86, 0.96], p < 0.001) and lower mortality (Odds Ratio [OR] = 0.59; 95% CI [0.45, 0.78], p < 0.001). Main predictors of survival in subgroup analyses were emotional and physical well-being, optimism, and vitality.
Why it matters
It provides pooled observational evidence that positive psychological states correlate with extended survival in cancer patients, expanding prognostic research beyond negative affect and distress.
Limits
The included literature consists of observational longitudinal studies prone to residual confounding and reverse causation (e.g., less severe cancer stage driving higher positive affect). The abstract omits cancer stage breakdowns, treatment variables, and heterogeneity metrics.
Cited by
- supports Studies demonstrate that an optimistic versus pessimistic psychological attitude statistically correlates with differences in disease recovery, life expectancy, and disease-free days.