Tao Lin, Xiang Yuping, Zeng Xiaohong, Fu Lan, Li Junying, Chen Hong
Cancer Day-Care Unit, Division of Medical Oncology, Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.
Department of Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.
Front Psychiatry. 2024 Mar 13;15:1309702. doi: 10.3389/fpsyt.2024.1309702. eCollection 2024.
Cancer-related distress can be described as a complex and unpleasant combination of psychological (such as cognitive, behavioral, and emotional), social, and spiritual challenges that may impact an individual's ability to effectively cope with the physical symptoms of cancer and its treatment. Existing literature has confirmed psychological distress (PD) as an important sequela of breast cancer diagnosis and treatment. However, the incidence and risk factors for PD in adult female patients with breast cancer remain unclear; therefore, focusing on the PD of female breast cancer patients is meaningful, as they are at highest risk of contracting breast cancer, and might differ in their coping styles from men.
This review aimed to identify the incidence and risk factors for PD in adult woman patients with breast cancer, and to help guide targeted intervention to prevent distress.
PubMed, Embase, Cochrane Library, CINAL, PsycINFO, China Knowledge Resource Integrated Database, Wanfang Database, the Chinese Biomedical Database, and Weipu Database were searched for data regarding the incidence and risk factors of PD in adult women with breast cancer.
The prevalence of PD, assessed using the distress thermometer, ranged between 11.2%-86.7%, and a meta-analysis of 47 studies with 15,157 adult female breast cancer patients showed that the pooled prevalence was 52.0%. Further, this study identified 40 risk factors. However, owing to the inclusion of at least two studies for a certain risk factor, 10 risk factors were merged for the meta-analysis. Independent risk factors included higher education level, late-stage tumor, emotional concerns, no medical insurance, modified radical mastectomy, and history of depression; age and neuroticism were not associated with PD; and higher monthly income was revealed as a protective factor against it.
The incidence of PD in female patients with breast cancer is high and it involves 10 risk factors, though some are controversial owing to insufficient evidence. Further research is needed to explore the underlying mechanisms of PD and develop risk factor-based holistic intervention programs to reduce its incidence.
The protocol of this study has been registered in the database PROSPERO (registration ID: CRD42023433578).
癌症相关困扰可被描述为心理（如认知、行为和情绪方面）、社会和精神挑战的复杂且不愉快的组合，这些挑战可能会影响个体有效应对癌症及其治疗的身体症状的能力。现有文献已证实心理困扰（PD）是乳腺癌诊断和治疗的重要后遗症。然而，成年女性乳腺癌患者中PD的发病率及风险因素仍不明确；因此，关注女性乳腺癌患者的PD具有重要意义，因为她们患乳腺癌的风险最高，且应对方式可能与男性不同。
本综述旨在确定成年女性乳腺癌患者中PD的发病率及风险因素，并帮助指导针对性干预以预防困扰。
检索了PubMed、Embase、Cochrane图书馆、CINAL、PsycINFO、中国知网、万方数据库、中国生物医学数据库和维普数据库，以获取有关成年女性乳腺癌患者中PD发病率及风险因素的数据。
使用困扰温度计评估的PD患病率在11.2%至86.7%之间，对47项研究中15157名成年女性乳腺癌患者进行的荟萃分析表明，合并患病率为52.0%。此外，本研究确定了40个风险因素。然而，由于某个风险因素至少纳入了两项研究，因此将10个风险因素合并用于荟萃分析。独立风险因素包括较高的教育水平、晚期肿瘤、情绪问题、无医疗保险、改良根治性乳房切除术和抑郁症病史；年龄和神经质与PD无关；较高的月收入被证明是预防PD的保护因素。
女性乳腺癌患者中PD的发病率较高，涉及10个风险因素，尽管由于证据不足，其中一些存在争议。需要进一步研究以探索PD的潜在机制，并制定基于风险因素的整体干预方案以降低其发病率。
本研究方案已在PROSPERO数据库中注册（注册号：CRD42023433578）。
