Are psychological interventions effective on anxiety in cancer patients? A systematic review and meta-analyses

The aim of this meta-analysis was to estimate the overall effect size (ES) of psychological interventions on anxiety in patients with cancer; and extract sample and intervention characteristics that influence effectiveness. PubMed, Scopus, PsycINFO, Embase, Medline and CINAHL were searched using Medical Subject Heading keywords- 'cancer' AND 'anxiety' AND 'psychological intervention' AND 'counselling' AND 'psycho*' AND 'psychotherapy' AND 'psychosocial' AND 'therapy' between January 1993- June 2017. Seventy-one studies were eligible for the systematic review; among them 51 studies were included in the meta-analysis calculations. The overall ES was -0.21 (95% confidence interval; -0.30 to -0.13) in favour the intervention. From sub-group analyses, studies conducted in Asia; enrolling inpatients; focussing on relaxation; of Low psychological distress at baseline and non-evidence based interventions were the main factors identified for low effectiveness. Screening and assessment to determine clinical levels of anxiety in patients with cancer should be considered in future trials as an inclusion criterion before providing psychological interventions.