The Impact of Spirituality, Religiosity, and Quality of Life on the Survival of Patients with Head-and-Neck Squamous Cell Carcinoma in Brazil: A Cohort Study

Abstract This prospective cohort study investigated whether spirituality, religiosity, emotional symptoms, and quality of life were associated with survival in patients with head-and-neck squamous cell carcinoma (HNSCC) treated at a tertiary referral center in Brazil. A total of 245 adults were enrolled at baseline, including 118 patients with HNSCC and 127 companions without a history of cancer. Only the 118 HNSCC patients were included in the survival analyses. Participants were evaluated using validated instruments for religiosity/spirituality, depression, anxiety, and quality of life. Survival time was calculated in days from baseline assessment to death or censoring, and associations with psychosocial variables were examined using bivariate comparisons, complementary correlation analyses, and Kaplan–Meier survival curves. During follow-up, patients who died had significantly higher depressive symptom scores and lower organizational religiosity than survivors. Longer survival was positively associated with organizational religiosity and self-rated quality of life, whereas depressive symptoms were inversely associated with survival duration. These findings suggest that greater organizational religiosity and better self-perceived quality of life may be associated with longer survival in patients with HNSCC. In contrast, depressive symptoms may be associated with poorer survival outcomes.