Depression and anxiety in long-term cancer survivors compared with spouses and healthy controls: a systematic review and meta-analysis

作者：Mitchell Alex J^*; Ferguson David W; Gill John; Paul Jim; Symonds Paul

来源：Lancet Oncology, 2013, 14(8): 721-732.

DOI：10.1016/S1470-2045(13)70244-4

Background Cancer survival has improved in the past 20 years, affecting the long-term risk of mood disorders. We assessed whether depression and anxiety are more common in long-term survivors of cancer compared with their spouses and with healthy controls. %26lt;br%26gt;Methods We systematically searched Medline, PsycINFO, Embase, Science Direct, Ingenta Select, Ovid, and Wiley Interscience for reports about the prevalence of mood disorders in patients diagnosed with cancer at least 2 years previously. We also searched the records of the International Psycho-oncology Society and for reports that cited relevant references. Three investigators independently extracted primary data. We did a random-effects meta-analysis of the prevalences of depression and anxiety in cancer patients compared with spouses and healthy controls. %26lt;br%26gt;Findings Our search returned 144 results, 43 were included in the main analysis: for comparisons with healthy controls, 16 assessed depression and ten assessed anxiety; of the comparisons with spouses, 12 assessed depression and five assessed anxiety. The prevalence of depression was 11.6% (95% CI 7.7-16.2) in the pooled sample of 51 381 cancer survivors and 10.2% (8.0-12.6) in 217 630 healthy controls (pooled relative risk [RR] 1.11, 95% CI 0.96-1.27; p=0.17). The prevalence of anxiety was 17.9% (95% CI 12.8-23.6) in 48 964 cancer survivors and 13.9% (9.8-18.5) in 226 467 healthy controls (RR 1.27, 95% CI 1.08-1.50; p=0.0039). Neither the prevalence of depression (26.7% vs 26.3%; RR 1.01, 95% CI 0.86-1.20; p=0.88) nor the prevalence of anxiety (28.0% vs 40.1%; RR 0.71, 95% CI 0.44-1.14; p=0.16) differed significantly between cancer patients and their spouses. %26lt;br%26gt;Interpretation Our findings suggest that anxiety, rather than depression, is most likely to be a problem in long-term cancer survivors and spouses compared with healthy controls. Efforts should be made to improve recognition and treatment of anxiety in long-term cancer survivors and their spouses.

• 出版日期2013-7