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

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.