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      Mindfulness‐based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta‐analysis of randomized controlled trials

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          Abstract

          Objective

          Mindfulness‐based interventions (MBIs) are increasingly used within psycho‐oncology. Since the publication of the most recent comprehensive meta‐analysis on MBIs in cancer in 2012, the number of published trials has more than doubled. We therefore conducted a systematic review and meta‐analysis of randomized controlled trials (RCTs), testing the efficacy of MBIs on measures of psychological distress (primary outcome) and other health outcomes in cancer patients and survivors.

          Methods

          Two authors conducted independent literature searches in electronic databases from first available date to 10 October 2018, selected eligible studies, extracted data for meta‐analysis, and evaluated risk of bias.

          Results

          Twenty‐nine independent RCTs (reported in 38 papers) with 3274 participants were included. Small and statistically significant pooled effects of MBIs on combined measures of psychological distress were found at post‐intervention (Hedges's g = 0.32; 95%CI: 0.22‐0.41; P < .001) and follow‐up ( g = 0.19; 95%CI: 0.07‐0.30; P < .002). Statistically significant effects were also found at either post‐intervention or follow‐up for a range of self‐reported secondary outcomes, including anxiety, depression, fear of cancer recurrence, fatigue, sleep disturbances, and pain ( g: 0.20 to 0.51; p: <.001 to.047). Larger effects of MBIs on psychological distress were found in studies (a) adhering to the original MBI manuals, (b) with younger patients, (c) with passive control conditions, and (d) shorter time to follow‐up. Improvements in mindfulness skills were associated with greater reductions in psychological distress at post‐intervention.

          Conclusions

          MBIs appear efficacious in reducing psychological distress and other symptoms in cancer patients and survivors. However, many of the effects were of small magnitude, suggesting a need for intervention optimization research.

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          Most cited references56

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          The nuts and bolts of PROSPERO: an international prospective register of systematic reviews

          Background Following publication of the PRISMA statement, the UK Centre for Reviews and Dissemination (CRD) at the University of York in England began to develop an international prospective register of systematic reviews with health-related outcomes. The objectives were to reduce unplanned duplication of reviews and provide transparency in the review process, with the aim of minimizing reporting bias. Methods An international advisory group was formed and a consultation undertaken to establish the key items necessary for inclusion in the register and to gather views on various aspects of functionality. This article describes the development of the register, now called PROSPERO, and the process of registration. Results PROSPERO offers free registration and free public access to a unique prospective register of systematic reviews across all areas of health from all around the world. The dedicated web-based interface is electronically searchable and available to all prospective registrants. At the moment, inclusion in PROSPERO is restricted to systematic reviews of the effects of interventions and strategies to prevent, diagnose, treat, and monitor health conditions, for which there is a health-related outcome. Ideally, registration should take place before the researchers have started formal screening against inclusion criteria but reviews are eligible as long as they have not progressed beyond the point of completing data extraction. The required dataset captures the key attributes of review design as well as the administrative details necessary for registration. Submitted registration forms are checked against the scope for inclusion in PROSPERO and for clarity of content before being made publicly available on the register, rejected, or returned to the applicant for clarification. The public records include an audit trail of major changes to planned methods, details of when the review has been completed, and links to resulting publications when provided by the authors. Conclusions There has been international support and an enthusiastic response to the principle of prospective registration of protocols for systematic reviews and to the development of PROSPERO. In October 2011, PROSPERO contained 200 records of systematic reviews being undertaken in 26 countries around the world on a diverse range of interventions.
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            The file drawer problem and tolerance for null results.

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              Cancer survivors in the United States: prevalence across the survivorship trajectory and implications for care.

              Cancer survivors represent a growing population, heterogeneous in their need for medical care, psychosocial support, and practical assistance. To inform survivorship research and practice, this manuscript will describe the prevalent population of cancer survivors in terms of overall numbers and prevalence by cancer site and time since diagnosis. Incidence and survival data from 1975-2007 were obtained from the Surveillance, Epidemiology, and End Results Program and population projections from the United States Census Bureau. Cancer prevalence for 2012 and beyond was estimated using the Prevalence Incidence Approach Model, assuming constant future incidence and survival trends but dynamic projections of the U.S. population. As of January 1, 2012, approximately 13.7 million cancer survivors were living in the United States with prevalence projected to approach 18 million by 2022. Sixty-four percent of this population have survived 5 years or more; 40% have survived 10 years or more; and 15% have survived 20 years or more after diagnosis. Over the next decade, the number of people who have lived 5 years or more after their cancer diagnosis is projected to increase approximately 37% to 11.9 million. A coordinated agenda for research and practice is needed to address cancer survivors' long-term medical, psychosocial, and practical needs across the survivorship trajectory. Prevalence estimates for cancer survivors across the survivorship trajectory will inform the national research agenda as well as future projections about the health service needs of this population.
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                Author and article information

                Contributors
                linda.cillessen@radboudumc.nl
                Journal
                Psychooncology
                Psychooncology
                10.1002/(ISSN)1099-1611
                PON
                Psycho-Oncology
                John Wiley and Sons Inc. (Hoboken )
                1057-9249
                1099-1611
                11 September 2019
                December 2019
                : 28
                : 12 ( doiID: 10.1002/pon.v28.12 )
                : 2257-2269
                Affiliations
                [ 1 ] Center for Mindfulness, Department of Psychiatry Radboud University Medical Center Nijmegen the Netherlands
                [ 2 ] Donders Institute for Brain, Cognition and Behavior Radboud University Nijmegen the Netherlands
                [ 3 ] Unit for Psychooncology and Health Psychology Aarhus University Hospital and Aarhus University Aarhus Denmark
                Author notes
                [*] [* ] Correspondence

                Linda Cillessen, Department of Psychiatry, Center for Mindfulness, Radboud University Medical Center, (966/CvM), Postbus 9101, 6500 HB, Nijmegen, the Netherlands.

                Email: linda.cillessen@ 123456radboudumc.nl

                Author information
                https://orcid.org/0000-0003-2030-8646
                https://orcid.org/0000-0002-7849-7534
                https://orcid.org/0000-0001-5266-1554
                https://orcid.org/0000-0001-9076-3068
                Article
                PON5214 PON-19-0341.R2
                10.1002/pon.5214
                6916350
                31464026
                ee561809-486d-4646-8a31-afad05880766
                © 2019 The Authors. Psycho‐Oncology published by John Wiley & Sons Ltd

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 09 May 2019
                : 19 August 2019
                : 21 August 2019
                Page count
                Figures: 2, Tables: 3, Pages: 13, Words: 4554
                Categories
                Review
                Reviews
                Custom metadata
                2.0
                December 2019
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.7.3 mode:remove_FC converted:17.12.2019

                cancer,meta‐analysis,mindfulness,mindfulness‐based cognitive therapy,mindfulness‐based stress reduction,oncology,systematic review

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