Global and regional geographical prevalence of depression in gastric cancer: a systematic review and meta-analysis

Background Substantial uncertainty exists about the prevalence of depression in patients with gastric cancer. We aimed to summarise the global and regional pooled prevalence of depression among patients with gastric cancer. Method Up to February 2020, we searched PubMed/MEDLINE, Embase, Scopus, Web of science (ISI) and PsychINFO to identify published studies on the prevalence of depression among patients with gastric cancer. The study selection procedure was in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We estimated the prevalence of depression in gastric cancer patients using a random-effect pooled estimate analysis approach with subgroup analysis based on WHO regions, and methods of depression measurement. Results Totally, we retrieved 3781 studies from the previously mentioned databases, of which 18 (12 cross-sectional and 6 cohort studies in design) met the eligibility criteria, which were published from 2001 to 2017 in different regions. The total sample size of the included studied contained 4709 patients with gastric cancer, of which 1885 cases were diagnosed with depression. The pooled prevalence of depression among gastric cancer patients was 37%(95% CI: 26% to 48%). Subgroup analysis showed that the highest prevalence of depression was in Eastern Mediterranean (pooled prevalence=42%; 95% CI: 18% to 65%) followed by the Western Pacific region (pooled prevalence=40%;95% CI: 26% to 54%). The results indicated a significant heterogeneity ( I 2 =98.8%, P <0.05). Conclusion Our findings indicated that depression is high among gastric cancer patients. The findings suggest health authorities to provide specially designed social and psychological supportive care services, including screening for depression, among such patients. PROSPERO registration number CRD42020139836.