Prevalence of low resilience among adults with cancer: a Meta-Analysis

Cancer is increasingly recognized as a long-term condition accompanied by persistent psychological and social challenges. Psychological resilience, defined as the capacity to adapt to adversity, has been identified as an important protective factor for mental health and quality of life among patients with cancer. Although resilience is commonly studied as a continuous construct, the prevalence of low resilience—which is critical for clinical screening and psychosocial care planning—has not been systematically quantified. This study is a systematic review and meta-analysis aiming to estimate the pooled prevalence of low psychological resilience among adult patients with cancer. The review synthesizes observational studies that classified participants as having low resilience using validated instruments, including both predefined cut-off scores and data-driven classifications such as latent profile analysis. Random-effects meta-analysis of proportions using generalized linear mixed models was employed to account for between-study heterogeneity. Subgroup analyses were conducted to explore sources of heterogeneity according to resilience measurement instrument, cut-off definition, population status (patients undergoing active treatment vs. cancer survivors), and study risk of bias. Sensitivity analyses and assessments of small-study effects were performed to evaluate the robustness of findings. By providing a pooled prevalence estimate and characterizing variability across studies, this review aims to inform psychosocial oncology practice, support resource planning, and guide future research on resilience vulnerability in cancer populations.