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248 Background: Although cancer patients frequently use CAM, it is uncertain how oncologists’ spirituality and religiosity impact their decisions to use or recommend CAM with their patients. Methods: A US probability sample of 1,000 ASCO members was contacted by mail and email to complete a survey regarding clinical approaches to herb and supplement (HS) use by cancer patients. Results: Of 927 deliverable surveys, 423 surveys were returned for a response rate of 46%. Respondents were mostly men (72%), Caucasian (76%), with a median age of 48. Approximately 16% reported no religion, 19% Jewish, 24% Catholic, 28% Christian, and 13% other religions. Eighteen percent reported attending religious services at least once a week including 15% who attend several times per week. Twenty-eight percent reported high theological pluralism (skepticism regarding whether one religion is the only true religion). Fifty-eight percent self-described themselves as very or moderately spiritual. Univariate analyses indicated significant correlations with self-reported spirituality and religious service attendance and the likelihood of personal CAM use, recommending any CAM, and recommending HS. In multivariate analyses, predictors of personal CAM use were: female gender (OR = 5.6, CI 0.09-0.37), non-Caucasian (OR = 3.0, CI 0.16-0.70), educated in HS (OR = 2.6, CI 1.37-5.08), attending religious services less than monthly (OR = 3.0, CI 0.17-0.65), and self –reported high or moderate spirituality (OR = 3.2, CI 1.5-6.6). Physician predictors for sometimes or often recommending HS were male gender (OR = 1.85, CI 0.92-3.75) and self–reported low spirituality (OR = 2.9, CI, 0.15-0.77). Recommending CAM was associated with female gender (OR = 2.6, CI 0.15-0.97), educated in HS (OR = 3.4, CI 1.46-7.78), and self–reported high or moderate spirituality (OR = 2.8, CI 1.26-6.31). No correlations were found with religious affiliation. Conclusions: This is the first study to identify self-reported spirituality as a significant factor among US oncologists’ decision to use CAM and recommend CAM to patients, and further studies are needed to explore this potential influence.