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Epidemiology and Health 2019;e2019030.
DOI: https://doi.org/10.4178/epih.e2019030    [Accepted] Published online Jul 4, 2019.
Meta-Analysis of High Prevalence of Depression among Breast Cancer Survivors in Iran: Calling Community Supportive Care Programs
Hasan Ahmadi Gharaei1  , Mostafa Dianati nasab2  , Seyyed Mostafa Kouhestani3  , Mohammad Fararouei4  , Hossein Moameri1  , Reza Pakzad1  , Reza Ghaiasvand5 
1Department of Epidemiology, Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
2Department of Epidemiology, Tehran University of Medical Sciences, Tehran, Iran
3School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
4Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
5Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
Correspondence  Mostafa Dianati nasab ,Tel: +987137251020, Fax: +987137251020, Email: dianati.epid@shmu.ac.ir
Received: May 15, 2019  Accepted after revision: Jul 4, 2019
Depression is the most common comorbidity in breast cancer (BC) patients which has adverse effects on patients’ quality of life (QoL), disease progress and survival.
The study protocol was registered in the PROSPERO (registration number: CRD42019121494). We electronically searched published studies up to January 2019 with the aim of finding articles that investigated the prevalence of depression among breast cancer survivors. Web of Science (ISI), Scopus, PubMed/Medline, Science Direct and Google Scholar were searched to obtain the relevant published studies. This review included 15 cross-sectional and 3 cohort studies published from 2000 to 2018. We used a random effects model to conduct the meta-analysis and generate a summary estimate for the pooled prevalence with 95% confidence interval (CI). Subgroup analysis was also conducted based on depression assessment tool and study design.
The total sample size of the studied patients contained 2799 women with breast cancer which included 1228 cases who were diagnosed with depression. The pooled prevalence of depression among Iranian women with BC was 46.8% (95% CI: 33.8% – 59.9%) with significant heterogeneity (I2= 98.7% (p< 0.001). The prevalence of depression ranged from 14.00 % (95% CI: 4.9%-23.1%) to 95.9% (95% CI: 91.97%-99.83%). The results of subgroup analyses suggested that depression measuring tools, years of publication and study design were the source of heterogeneity.
Our findings indicate a high prevalence of depression among breast cancer patients. The findings urge clinicians and health authorities to provide well defined social and psychological supportive care program for these patients.
Keywords: Breast cancer; Supportive care; Depression; Prevalence; Meta-analysis; Iran
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