Prevalence and influencing factors of fear of disease progression among cancer survivors in China: a meta-analysis

  Objective  To explore the prevalence and main influencing factors of fear of disease progression (FoP) in Chinese cancer survivors and to provide references for the prevention and control of mental health problems in cancer patients.

  Methods  We searched Chinese National Knowledge Infrastructure (CNKI), China Biomedical Database (CBM), Wanfang Database, Weipu Chinese Science Database and Technology Periodical Database (VIP), PubMed, Cochrane Library Database, Web of Science Database, Embase Database, PsycINFO Database, and CINAHL Database to retrieve literatures on the prevalence and influencing factors of FoP in Chinese cancer survivors published up to August 31, 2021. Stata MP 16.0 software was used to perform a meta-analysis.

  Results  Finally, 22 literatures (19 in Chinese and 3 in English) were included in the analysis, with a total of 6 461 participants. The meta-analysis results showed that the prevalence of FoP in Chinese cancer survivors was 51.0% (95% confidence interval 95% CI : 42.0% – 61.0%). The results of subgroup analysis revealed that the prevalence of FoP differed significantly among cancer survivors in different regions (χ² = 843.3, P < 0.05 ), with the prevalence rates of 56.0%, 54.0% and 42.0% for cancer survivors in South, Central and East China; the prevalence also varied among the survivors suffering from cancer of various systems (χ² = 843.3, P < 0.05 ) and the prevalence rate was 40.0%, 56.0%, 58.0% and 54.0% for the survivors with digestive tract, gynecological, hematological and respiratory malignancies, respectively. The meta-analysis revealed that age, average monthly income, clinical stage of the malignancy, educational level, marital status, employment, disease course, family history of cancer, and anxiety were influencing factors for FoP among the survivors. The results of meta-regression analysis demonstrated that the sources of heterogeneity of the included studies were associated with following characteristics of the survivors: aged < 40 years ( β = 4.29, P = 0.018 ), monthly income of 1 000 – 2 999 (RMB yuan, β = – 3.80, P = 0.032 ), monthly income of 3 000 – 4 999 ( β = – 4.56, P = 0.011 ), monthly income of ≥ 5 000 ( β = – 8.70, P = 0.000 ), and with the malignancy of clinical stage I ( β = – 5.55,P = 0.020 ). Sensitivity analysis indicated that the results of the meta-analysis were stable; the results of Egger′ test and funnel plot demonstrated that the publication bias was less likely to present for the studied indicators, except for family history.

  Conclusion  The prevalence of FoP is relatively high among Chinese cancer survivors and the prevalence varies among survivors living in different regions and with different clinical stage of the malignancy; the FoP prevalence is mainly influenced by survivors′ age, monthly income, clinical stage of the malignancy, education, marital status, employment, disease course, family history of malignancy, and anxiety symptom.