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Role of Religiosity and Spirituality in Complementary and Alternative Medicine Use Among Cancer Survivors in California

VA Long Beach Healthcare System, Long Beach, California, Center for Health Policy Research, University of California, Irvine, California, anfu.hsiao{at}va.gov

Mitchell D. Wong, MD, PhD

Division of General Internal Medicine and Health Services Research, University of California, Los Angeles

Melissa F. Miller, PhD, MPH

Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland

Anita H. Ambs

Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland

Michael S. Goldstein, PhD

Department of Community Health Sciences, University of California, Los Angeles

Ashley Smith

Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland

Rachel Ballard-Barbash, MD, MPH

Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland

Lida S. Becerra

UCLA Center for Health Policy and Research, Los Angeles, CA

Eric M. Cheng, MD

Department of Neurology, University of California, Los Angeles, VA Greater Los Angeles Healthcare System, Los Angeles

Neil S. Wenger, MD

Division of General Internal Medicine and Health Services Research, University of California, Los Angeles

Objectives. Cancer survivors often turn to religion, spirituality, and complementary and alternative medicine (CAM) because they perceive these areas as being more holistic and patient-centered than conventional medicine. Because increased religiosity and spirituality have been found to be associated with higher CAM use in the general population, it was hypothesized that these factors would be important predictors of CAM use in cancer survivors. Design and Subjects. The study included a subsample of 1844 people with cancer or a history of cancer from the 2003 California Health Interview Survey of CAM, a cross-sectional survey of a population-based sample of adults in California. Prevalence and predictors of religious/spiritual forms of CAM (R/S CAM) and nonreligious/nonspiritual forms of CAM (non-R/S CAM) were compared. Multivariate logistic regression was used to identify the predictors of R/S CAM and non-R/S CAM. Results. Nearly two thirds of participants reported using at least 1 type of R/S CAM, and 85% reported ever using non-R/S CAM. The majority of cancer survivors reported that they were very/moderately religious or spiritual. Both religiosity and spirituality were strongly related to non-R/S CAM use, but in opposite directions. Very or moderately religious cancer survivors were less likely (odds ratio = 0.30; 95% confidence interval, 0.12-0.40) than nonreligious cancer survivors to use non-R/S CAM. In contrast, very or moderately spiritual cancer survivors were more likely (odds ratio = 2.42; 95% confidence interval, 1.16-6.02) than nonspiritual cancer survivors to use non-R/S CAM. Conclusions. The use of R/S CAM and non-R/S CAM is very high in cancer survivors. It may be helpful for clinicians to ascertain their patients' use of these types of CAM to integrate all forms of care used to managing their cancer.

Key Words: CAM • integrative medicine • spirituality • religiosity • survivors

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