A meta-analysis of prevalence rates and moderating factors for cancer-related post-traumatic stress disorder
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OBJECTIVE: Systematic reviews highlight a broad range of cancer-related post-traumatic stress disorder (CR-PTSD) prevalence estimates in cancer survivors. This meta-analysis was conducted to provide a prevalence estimate of significant CR-PTSD symptoms and full diagnoses to facilitate the psychological aftercare of cancer survivors. METHODS: A systematic literature search was conducted for studies using samples of cancer survivors by using validated clinical interviews and questionnaires to assess the prevalence of CR-PTSD (k = 25, n = 4189). Prevalence estimates were calculated for each assessment method using random-effects meta-analysis. Mixed-effects meta-regression and categorical analyses were used to investigate study-level moderator effects. RESULTS: Studies using the PTSD Checklist-Civilian Version yielded lower event rates using cut-off [7.3%, 95% confidence intervals (CI) = 4.5-11.7, k = 10] than symptom cluster (11.2%, 95% CI = 8.7-14.4, k = 9). Studies using the Structured Clinical Interview for Diagnostic and Statistical Manual, Fourth Edition (SCID), yielded low rates for lifetime (15.3%, 95% CI = 9.1-25, k = 5) and current CR-PTSD (5.1%, 95% CI = 2.8-8.9, k = 9). Between-study heterogeneity was substantial (I(2) = 54-87%). Studies with advanced-stage samples yielded significantly higher rates with PTSD Checklist-Civilian Version cluster scoring (p = 0.05), and when assessing current CR-PTSD on the SCID (p = 0.05). The effect of mean age on current PTSD prevalence met significance on the SCID (p = 0.05). SCID lifetime prevalence rates decreased with time post-treatment (R(2) = 0.56, p < 0.05). DISCUSSION: The cancer experience is sufficiently traumatic to induce PTSD in a minority of cancer survivors. Post-hoc analyses suggest that those who are younger, are diagnosed with more advanced disease and recently completed treatment may be at greater risk of PTSD. More research is needed to investigate vulnerability factors for PTSD in cancer survivors. © 2014 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.
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Most included measures of cancer-specific distress assessed cancer-related post-traumatic stress symptoms, which tend to be endorsed at low levels compared with fear of recurrence and general distress.
“First, most of the included measures of cancer-specific distress assessed cancer-related post-traumatic stress symptoms, which tend to be endorsed at low levels compared to fear of recurrence and general distress (Abbey et al., 2015).”
From The relationship between acceptance of cancer and distress: A meta-analytic review (2019) · cites this paper as Abbey et al., 2015
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- Authors
- Abbey, G., Thompson, S. B. N., Hickish, T., & Heathcote, D.
- Affiliations
- Bournemouth University (GB)
- Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust (GB)
- Corresponding author
- Abbey, Gareth
- Venue
- Psycho-Oncology
- Publisher
- Wiley
- Published
- 2014-08-22
- Volume
- 24
- Issue
- 4
- Pages
- 371-381
- ISSN
- 1057-9249 (ISSN-L)
- 1099-1611
- PMC
- PMC4409098
- OpenAlex
- W2114153779
- Cited by
- 280
- References
- 68
- Citations by year
- 2026: 25 · 2025: 52 · 2024: 28 · 2023: 23 · 2022: 27 · 2021: 22 · 2020: 26 · 2019: 29 · 2018: 11 · 2017: 14 · 2016: 9 · 2015: 12 · 2013: 1
- FWCI
- 1.33
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Psycho-Oncology (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Bournemouth University Research Online (Bournemouth University) (submittedVersion)
- Solent University Research Portal (Solent University) (submittedVersion, other-oa)
- Funders
- Bournemouth University
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Keywords
- cancer survivors, prevalence, PTSD Checklist-Civilian Version, severe combined immunodeficiency, symptom clusters, advanced cancer, age as risk factor, time since treatment
- MeSH terms
- Age Factors, Humans, Neoplasms, Risk Factors, Severity of Illness Index, Stress Disorders, Post-Traumatic, Prevalence, Survivors
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