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Objectives: There is evidence that cancer generates existential and spiritual concerns for both survivors and caregivers, and that the survivor's spiritual well-being (SWB) is related to his/her own quality of life (QOL). Yet the degree to which the SWB of each member of the couple has an independent association with the partner's QOL is unknown. Thus, this study examined individual and dyadic associations of SWB with the QOL of couples dealing with cancer., Methods: A total of 361 married survivor-caregiver dyads participating in the American Cancer Society's Study of Cancer Survivors-I and Quality of Life Survey for Caregivers provided complete data for the study variables. SWB was measured using 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (assessing faith, meaning, and peace) and QOL was measured using Medical Outcomes Study 36-Item Short Form Health Survey., Results: Actor and Partner Interdependence Model analyses revealed that each person's SWB was the strongest correlate of his or her own mental health (higher SWB, better mental health). Each person's SWB was also positively related to his or her partner's physical health., Conclusions: Results suggest that the ability to find meaning and peace may be an important part of overall well-being during the cancer experience for both survivors and caregivers. Interventions designed to assist survivors and caregivers to enhance their ability to find meaning and peace in the cancer experience may help them improve mental health of their own and the physical health of partners when they are dealing with cancer beyond the initial phase of the illness trajectory., (Copyright © 2010 John Wiley & Sons, Ltd.)

Objectives: Recent confirmatory factor analysis (CFA) of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) Scale in a sample of predominantly white women demonstrated that three factors, Meaning, Peace, and Faith, represented a psychometric improvement over the original 2-factor model. The present study tested these findings in a more diverse sample, assessed the stability of the model across racial/ethnic groups, and tested the contribution of a new item., Methods: In a study by the American Cancer Society, 8805 cancer survivors provided responses on the FACIT-Sp, which we tested using CFA., Results: A 3-factor model provided a better fit to the data than the 2-factor model in the sample as a whole and in the racial/ethnic subgroups (Deltachi(2), p<0.001, for all comparisons), but was not invariant across the groups. The model with equal parameters for racial/ethnic groups was a poorer fit to the data than a model that allowed these parameters to vary (Deltachi(2)(81)=2440.54, p<0.001), suggesting that items and their associated constructs might be understood differently across racial/ethnic groups. The new item improved the model fit and loaded on the Faith factor., Conclusions: The 3-factor model is likely to provide more specific information for studies in the field. In the construction of scales for use with diverse samples, researchers need to pay greater attention to racial/ethnic differences in interpretation of items.

Background: The medical and demographic correlates of complementary and alternative medicine (CAM) use among cancer survivors have been well documented. However, the role of psychological functioning in cancer survivors' CAM use and the degree to which such factors apply to survivors of colorectal cancer require additional study. In addition, sex differences in CAM use and its correlates among colorectal cancer survivors are not well understood., Methods: By using data from a large-scale national population-based study of quality of life and health behaviors among cancer survivors, the authors examined the prevalence and psychological correlates of CAM use among 252 male and 277 female colorectal cancer survivors., Results: Use of CAM was more common among women, those with more education, and recipients of chemotherapy and radiation therapy. Several psychological factors predicted increased use of CAM among female colorectal cancer survivors, including anxiety, fear of cancer recurrence, fatigue, vigor, anger, mental confusion, and overall emotional distress. Depression was associated with decreased CAM use among female survivors, both for overall CAM use and across several standard CAM domains. In contrast, psychological functioning had little impact on male colorectal cancer survivors' CAM use. The only nonmedical/demographic variable associated with men's use of CAM was fatigue, which predicted use only of biologically based practices, such as diet and nutritional supplements., Conclusions: Psychological functioning has a significant impact on CAM use among female colorectal cancer survivors. Decreased use of CAM among women with depressive symptoms was unexpected and warrants additional investigation., (Copyright (c) 2009 American Cancer Society.)

The field of cancer survivorship is characterized by a complex and rapidly evolving landscape. This supplement presents a series of data-driven articles selected to highlight the breadth of new knowledge in this area of the cancer control continuum that were presented at the Fourth Biennial Cancer Survivorship Research Conference in Atlanta, Georgia, June 2008. Included in the volume is research on the biobehavioral impact of cancer; studies on quality-of-life and economic outcomes; and work focused on caregivers, understudied populations, and healthcare providers.

Background: The use of complementary methods (CMs) is widespread and increasing in the United States. Most literature on CM use among cancer survivors focuses on the treatment period, whereas only a few studies address use further along the cancer continuum., Methods: This study analyzed the prevalence and the medical and demographic associations of CM use among cancer survivors surveyed 10 to 24 months after diagnosis. The study's sample-4139 survivors of 1 of 10 adult cancers-was selected from stratified random samples provided by statewide cancer registries and surveyed by mail and telephone. Three logistic regression models examined associations between medical and demographic factors and CM use among survivors of sex-specific and non-sex-specific cancers., Results: Of the 19 CMs included in the survey, the CMs most frequently reported were prayer/spiritual practice (61.4%), relaxation (44.3%), faith/spiritual healing (42.4%), nutritional supplements/vitamins (40.1%), meditation (15%), religious counseling (11.3%), massage (11.2%), and support groups (9.7%). Among these 19 CMs, the least prevalent were hypnosis (0.4%), biofeedback therapy (1.0%), and acupuncture/acupressure (1.2%). Survivors more likely to use CMs were female, younger, white, higher income, and more educated., Conclusions: This study provides information regarding prevalence and medical-demographic determinants of CM use reported by a large, population-based sample of survivors of 10 cancers surveyed 10 to 24 months after diagnosis. These findings may be used by clinicians and researchers to inform their decisions regarding which CMs to address in practice and research., ((c) 2008 American Cancer Society.)

Background: Inaccurate beliefs about cancer risk may contribute to unhealthy lifestyle behaviors and poor adherence to recommended screening and prevention guidelines. To address this issue the current study assessed the prevalence and sociodemographic correlates of scientifically unsubstantiated beliefs about cancer risk in a representative sample of the US population., Methods: Nine hundred fifty-seven US adults with no history of cancer were surveyed by telephone. The survey included 12 statements about cancer risk, risk factors, and prevention that were framed to be contrary to the consensus of current scientific evidence., Results: Participants were inconsistent in their ability to identify the statements as false, and appraisal accuracy was associated with several sociodemographic characteristics. Five of the 12 misconceptions were endorsed as true by at least a quarter of the respondents, and uncertainty was higher than 15% for 7 statements. At the same time, more than two-thirds of the participants were able to identify 7 statements as false and, on average, respondents endorsed fewer than 3 statements as true. Respondents who were male, older, non-White, less educated, and of lower income were most likely to hold inaccurate beliefs., Conclusions: A notable percentage of the participants in this study hold beliefs about cancer risk at odds with the prevailing scientific evidence. Because the population segments with the least accurate knowledge also bear the greatest burden of cancer, areas for public education and intervention efforts are identified.