Prevalence and influencing factors of depressive and anxiety symptoms in cervical cancer patients during the peri-chemoradiotherapy period: A systematic review meta-analysis

BACKGROUND: To systematically evaluate the prevalence and influencing factors of depressive and anxiety symptoms in cervical cancer patients during the peri-chemoradiotherapy period. METHODS: A comprehensive search was conducted in PubMed, EMBASE, Web of Science, The Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, VIP Information, and China Biology Medicine disc for studies published from database inception to December 31, 2024. The focus was on the prevalence of depressive and anxiety symptoms in cervical cancer patients during the peri-chemoradiotherapy period. Two researchers independently screened the literature, assessed quality, and extracted data. Meta-analysis was performed using Review Manager 5.4 software. RESULTS: A total of 26 studies were included, involving 5681 participants. The meta-analysis showed that the prevalence of depressive symptoms was 46% (95% CI [36-55%]), anxiety symptoms was 45% (95% CI [39-51%]), and comorbid depressive and anxiety symptoms was 26% (95% CI [21-32%]). Factors influencing anxiety included educational level (OR = 1.92, 95% CI [1.02-3.59], P = .04), cancer stage (OR = 6.80, 95% CI [3.09-14.98], P < .05), and financial status (OR = 3.19, 95% CI [1.70-5.99], P < .05). Factors influencing depression included marital status (OR = 2.90, 95% CI [1.43-5.87], P < .05), educational level (OR = 2.89, 95% CI [1.32-6.31], P < .05), number of chemotherapy cycles (OR = 6.57, 95% CI [2.21-19.55], P < .05), cancer stage (OR = 2.65, 95% CI [1.41-5.00], P < .05), financial status (OR = 3.19, 95% CI [1.30-7.86], P < .05), family care (score) (OR = 4.24, 95% CI [2.02-8.87], P < .05), social support (score) (OR = 2.83, 95% CI [1.42-5.62], P < .05), and frequency of health education (OR = 3.44, 95% CI [1.06-11.08], P < .05). CONCLUSION: Educational level, cancer stage, financial status, marital status, number of chemotherapy cycles, family care, social support, and frequency of health education are significant factors influencing depressive and anxiety symptoms in cervical cancer patients during the peri-chemoradiotherapy period. Clinical healthcare providers should enhance psychological nursing and monitor psychological status to reduce depression and anxiety levels.