# Prolonged Grief-Related Symptoms Among Young Individuals After Loss of a Parent or Sibling to Cancer: A Systematic Review and Meta-Analysis

## TL;DR

This study finds that nearly half of young people who lose a parent or sibling to cancer experience prolonged grief symptoms, especially after losing a sibling.

## Contribution

The paper provides a meta-analysis of prolonged grief symptoms in young individuals after parental or sibling cancer-related loss, highlighting the need for better assessment tools.

## Key findings

- The pooled prevalence of prolonged grief-related symptoms was 48% among young individuals.
- Prolonged grief symptoms were more common after sibling death (59%) than parental death (28%).
- Risk factors included pre-existing depression, emotional difficulties, and insomnia.

## Abstract

Background/Objectives: Bereavement in childhood, adolescence, and young adulthood is associated with a range of grief responses, and a subset of bereaved individuals develop persistent or severe grief symptoms. Understanding the prevalence and risk factors of prolonged grief symptoms is important for guiding supportive care. Methods: We systematically searched PubMed, MedLine, Embase and PsycINFO for all studies comparing the prevalence and prognostic factors of prolonged grief-related symptoms among young individuals following parental or sibling death from cancer. Young individuals were defined as those not more than 25 years old before losing a parent or sibling to any cancer. Prolonged grief-related symptoms were defined as the presence of grief symptoms at least six months following the death of a parent or sibling of the bereaved person. Retrospective cross-sectional studies were included for evaluating prognostic factors affecting prolonged grief-related symptoms, but were not used for meta-analyses. Random-effects meta-analyses were conducted for the primary analysis. Results: From 1561 records identified, thirteen studies were included with five for quantitative pooling in meta-analysis. The pooled prevalence of self-reported prolonged grief-related symptoms was 48% (95% CI: 29–67%). Stratified analyses suggested a prevalence of 28% (95% CI: 7–65%) after parental death and 59% (95% CI: 45–72%) after sibling death. Factors associated with elevated prolonged grief-related symptoms included pre-existing depression, emotional difficulties, and insomnia. As no included studies conducted diagnostic clinical interviews, prolonged grief disorder according to the ICD-11 or DSM-5-TR criteria could not be assessed. Conclusions: Prolonged grief-related symptoms appear common among young individuals bereaved by loss of a parent or sibling to cancer, especially after sibling loss. However, interpretation remains limited by substantial heterogeneity, such as outcome measures, symptom thresholds, assessment time window, non-validated symptom measures, and predominance of cross-sectional studies. Future larger and methodologically rigorous studies using validated grief instruments across diverse settings are needed to clarify grief trajectories and guide developmentally appropriate intervention strategies.