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Anxiety and depression prevalence in digestive cancers: a systematic review and meta-analysis
  1. Mohammad Zamani1,2 and
  2. Shaghayegh Alizadeh-Tabari2
  1. 1Digestive Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2Student Research Committee, Babol University of Medical Science, Babol, Iran
  1. Correspondence to Dr Mohammad Zamani, Tehran University of Medical Sciences, Tehran, Iran; mzamani20{at}gmail.com

Abstract

Background Cancers of the digestive system can be associated with disturbing and disabling symptoms, which can contribute to a negative psychological pressure on patients.

Aim To investigate the reported prevalence of symptoms of anxiety and depression in patients with major digestive cancers, including oesophageal, gastric, colorectal, pancreatic or hepatic cancers.

Methods We searched Embase, PubMed, Scopus and Web of Science for articles published from inception to December 2020. We included studies reporting the prevalence of anxiety or depression symptoms using validated questionnaires in adult patients (≥18 years).

Results In total, 51 eligible papers were finally included. Overall, the pooled prevalence of anxiety symptoms was 20.4% (95% CI 17% to 23.8%). The estimate in patients with gastrointestinal (GI) cancers was 19.1% and in patients with hepatic cancer was 29.1%. Among GI cancers, the highest pooled prevalence of anxiety symptoms related to oesophageal cancer (20.6%), while the lowest pooled prevalence pertained to gastric cancer (18.7%). Regarding depression symptoms, the overall pooled prevalence was 30.2% (95% CI 24.3% to 36.1%). The estimate in patients with GI cancers was 31% and in patients with hepatic cancer was 21.5%. Among GI cancers, the highest pooled prevalence of depression symptoms related to oesophageal cancer (45.2%), while the lowest pooled prevalence pertained to colorectal cancer (22.9%).

Conclusion A considerable prevalence of anxiety and depression symptoms is observed in patients with digestive cancers. Screening and preventive measures with early management of these psychological problems by clinicians could possibly improve outcomes for these patients.

PROSPERO registration number CRD42020210079.

  • depression

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. No additional data are available.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. No additional data are available.

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Footnotes

  • Contributors MZ and SA-T conceived and designed the study and contributed to data collection and drafting of the manuscript. MZ contributed to data analysis. The authors have read the manuscript and approved its final version.

  • 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.

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