Published online Apr 19, 2022. doi: 10.5498/wjp.v12.i4.623
Peer-review started: August 31, 2021
First decision: December 12, 2021
Revised: December 20, 2021
Accepted: March 6, 2022
Article in press: March 6, 2022
Published online: April 19, 2022
Processing time: 224 Days and 11 Hours
Psychiatric disorders are common but underdiagnosed in cancer survivors. Research suggests that tumor type has an effect on the prevalence of clinically relevant depression, anxiety, comorbid anxiety-depression and posttraumatic stress disorder (PTSD) symptoms.
Detecting differences in the prevalence of four common mental disorders that can occur as a comorbidity in cancer survivors might lead to a better understanding of cancer survivors’ psychological distress. This might help to address the psychological concerns of cancer survivors more effectively.
The aim of this review was to identify studies in which clinically relevant levels of common mental disorders in cancer survivors were examined. The prevalence rates were compared among different cancer types.
Four databases were searched for studies that investigated cancer-free, posttreatment survivors with screening tools that assess clinically relevant levels of four common mental disorders. Two authors screened all articles, with a third author reviewing debated articles.
Twenty-six studies were included in the article and indicated the prevalence of one or more of the four mental disorders. Ten different tumor types were examined in the included papers. Generally, all four comorbidities show higher prevalences in cancer survivors than in the general population. The studies showed heterogeneity regarding the study characteristics, number of participants, time since diagnosis, and assessment tools. Each comorbid disorder had a variable prevalence across tumor subtypes. Within one cancer site, the prevalence also varied considerably among the studies.
Psychiatric comorbidities are high in cancer survivors relative to the general population, as reflected by the prevalences of depression, anxiety, comorbid anxiety-depression and PTSD across all tumor types. This enhanced distress is clinically relevant even years after a cancer diagnosis. The lack of a concise definition of cancer survivorship likely contributes to the high heterogeneity among studies focusing on cancer survivors’ psychological distress, which might hinder significant comparisons among studies.
Developing generalized screening tools that examine psychological distress in cancer survivors for at least ten years after diagnosis could help to understand and address the psychological burdens of the survivors.