Article Text

Download PDFPDF
Distress Thermometer in breast cancer: systematic review and meta-analysis
  1. Huihui Sun,
  2. Huimin Lv,
  3. Huiai Zeng,
  4. Limin Niu and
  5. Min Yan
  1. Department of Breast Disease, Henan Breast Cancer Center, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
  1. Correspondence to Dr Min Yan, Department of Breast Disease, Henan Cancer Hospital, Zhengzhou 450008, Henan, China; ym200678{at}


Objective This meta-analysis aimed to reach a summarised estimate of distress prevalence screened by Distress Thermometer (DT) among patients with breast cancer and compare different pooled prevalence estimated between different subgroups.

Methods Two independent interviewers conducted a systematic search from PubMed, EMBASE, Ovid and Cochrane Library and checked related reviews and meta-analyses for eligible studies. The studies that identified distress of patients with breast cancer with DT were included. After extracting demographic characteristics and distress prevalence, the pooled analysis and the forest plot were completed by using STATA V.12.0 software. We conducted a subgroup analysis based on demographic and methodological characteristics of the studies. The publication bias was estimated by funnel plot.

Results Seventeen studies describing 3870 patients with breast cancer were included in this meta-analysis. The distress prevalence of patients with breast cancer varied from 25.3% to 71.7% among these studies. The pooled distress prevalence was 50% (95% CI 49% to 52%) for the overall sample. The pooled distress prevalence rates in DT ≥7, DT ≥5 and DT ≥4 subgroups were 37% (95% CI 35% to 40%), 45% (95% CI 40% to 49%) and 62% (95% CI 60% to 65%), respectively. The distress prevalence had statistically significant differences between subgroups, which were differentiated by the initial time of distress identified, papers’ publication time, patients’ average age and country. There was no publication bias among the included studies.

Conclusion The distress prevalence was high among patients with breast cancer. Routine and timely screening of distress for patients with breast cancer is of great significance in oncology management.

  • breast
  • psychological care
  • quality of life
  • spiritual care

Data availability statement

All data relevant to the study are included in the article or uploaded as supplemental information. All data can be available.

Statistics from

Data availability statement

All data relevant to the study are included in the article or uploaded as supplemental information. All data can be available.

View Full Text


  • Contributors HS, MY and HL conceptualised and designed the study. HS, HL and HZ were responsible for literature searching and screening, and data collection. HS, HL and LN collected data, analysed and interpreted the data. HS drafted the initial manuscript. HL, HZ, LN and MY checked and corrected the manuscript. All authors have approved the final manuscript for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.