Poster Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

The impact of trauma history in adults receiving cancer care: A systematic review (126165)

Megan Jeon 1 , Matilda McLean 1 , Brian Kelly 2 , Kim Hobbs 3 , Rachel Zordan 4 , Vlatka Duric 1 , Laura Kirsten 5 , Joanne Shaw 1 , Haryana M Dhillon 1
  1. Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
  2. School of Medicine and Public Health, University of Newcastle (UON), Callaghan, NSW, Australia
  3. Oncology Social Work Australia New Zealand (OSWANZ), Australia
  4. Education and Learning, Victoria Parade, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
  5. Nepean Cancer Services , Nepean Blue Mountains Local Health District, Penrith, NSW, Australia

Objectives

Psychological and physical challenges of a cancer diagnosis and treatment may be exacerbated if a person has a history of trauma. This may affect many people with cancer as 75% of Australians have experienced a traumatic event during their life. While previous research mostly focused on the impact on cancer screening, we aimed to evaluate the broad-spectrum impact of a person’s trauma history on their cancer care outcomes.

Methods

We followed the PRISMA guidelines. A systematic search of three empirical databases (PsycINFO, MEDLINE, CINAHL) was conducted using key search terms of cancer and trauma. The evidence was independently screened and reviewed for inclusion and quality assessments. We narratively synthesised data by types of outcomes; clinical (excluding cancer screening), care/service delivery, survivorship, and psychological outcomes associated with a history of trauma in cancer survivors.

Results

Of 6637 records, 98 studies were included: 11 reporting pre-cancer trauma impact on diagnosis, 14 treatment, 4 survivorship, 42 psychological, 14 physical, 11 health-related quality of life, 2 care delivery outcomes. Compared to those without reported trauma history, pre-cancer trauma was associated with later stage diagnosis, particularly in refugees, homeless, women experiencing violence; greater deviance from standard treatment, treatment non-compliance, complications leading to unplanned surgery; lower survival rates; worse rating of physician communication/interaction. No differences were found for cost, hospitalisation, follow up, or disease progression. Childhood trauma, sexual and intimate partner violence were associated with poorer overall health, quality of life and physical symptoms (sleep, fatigue, pain, immunity). Trauma history was associated with elevated distress, anxiety, depression, and negative adjustment to cancer survivorship.

Conclusion and clinical implications

There are detrimental, wide-ranging impacts of trauma history in cancer survivors. Trauma-informed care is warranted to mitigate re-traumatisation and improve cancer care, psychological, and/or survivorship outcomes.