Systematic review and meta-analysis of cognitive-behavioural therapy for insomnia on subjective and actigraphy-measured sleep and comorbid symptoms in cancer survivors.

This systematic review and meta-analysis assessed the efficacy of cognitive-behavioural therapy for insomnia (CBT-I) among cancer survivors and explored its effect on comorbid symptoms. Studies were included if they assessed the efficacy of CBT-I in adults diagnosed with cancer published prior to August 2020. The primary outcome was insomnia severity. The protocol was pre-registered on PROSPERO (CRD42020169986). Twenty-two studies met eligibility criteria. CBT-I significantly improved insomnia severity (g = 0.78) with durable benefits at 3- and 6-month follow-up. CBT-I produced significant small to large effects for diary-measured sleep efficiency, wake after sleep onset, total sleep time, sleep onset latency, sleep quality, anxiety, depression, fatigue, and overall quality of life. Subgroup analyses revealed no significant difference between in-person and self-help CBT-I. Overall, CBT-I is a robustly efficacious and durable treatment for insomnia among cancer survivors and can produce concomitant benefits on other symptoms. Implementation efforts are needed to ensure that people with cancer have access to CBT-I as the recommended first-line treatment for insomnia.

Psychosocial Needs and Experiences of Transgender and Gender Diverse People with Cancer: A Scoping Review and Recommendations for Improved Research and Care.

The psychosocial needs and experiences of transgender and gender diverse (TGD) people is an understudied area of oncology research. In response to calls to action from past researchers, we conducted a scoping review, which included published and gray literature. From the included articles, the following key themes were identified: (1) lack of coordination between gender-affirming care and cancer care; (2) impact of cancer care on gender affirmation; (3) navigating gendered assumptions; (4) variation in providers' understanding of the needs of TGD patients; and (5) lack of TGD-specific cancer resources. Following this review, we consulted 18 key stakeholders with TGD-relevant personal and/or professional experience to gain further insight into issues that were not encompassed by the original themes. Based on these themes and stakeholder feedback, we offer recommendations for future research and clinical practice to increase awareness of the psychosocial needs of TGD people who have been diagnosed with cancer and to improve patient care.