Prevalence of anxiety and depression in breast cancer patients: a meta-analysis

Depression and anxiety are frequently reported among women with breast cancer, but prevalence estimates vary substantially across settings and assessment instruments. This meta-analysis synthesized recent international evidence and examined overall, severity-stratified, and instrument-specific prevalence estimates.

We searched PubMed, Web of Science, Embase, the Cochrane Library, APA PsycINFO, and Scopus for observational studies published from January 2015 through September 10, 2026. Proportions were pooled with a random-effects model after Freeman-Tukey double-arcsine transformation. Prespecified subgroup analyses examined region, assessment instrument, and study design; publication-year meta-regression and formal tests for small-study effects were also conducted. A quality-threshold sensitivity analysis re-included all otherwise eligible quality-appraised reports with extractable event counts and denominators.

Sixty-nine reports underwent quality appraisal; 52 entered the primary meta-analysis and 17 did not exceed the prespecified quality thresholds. The 52 reports represented 16,850 independent participants. Depression data comprised 49 reports and 16,504 participants, and anxiety data comprised 39 reports and 11,536 participants. The pooled prevalence was 44.3% for depression (95% CI: 38.3-50.4%; I ² = 98.3%) and 47.9% for anxiety (95% CI: 40.9-54.9%; I ² = 98.2%). Re-including all quality-appraised reports produced pooled estimates of 44.6% for depression (95% CI: 39.6-49.6%; 66 reports) and 48.1% for anxiety (95% CI: 41.0-55.3%; 53 reports), absolute changes of 0.27 and 0.24 percentage points, respectively. Publication year was not a significant moderator for either outcome.

Depression and anxiety symptoms were frequently reported, but estimates varied markedly across populations and instruments. The pooled estimates should be interpreted as descriptive summaries rather than precise universal prevalence values. Study-defined severity estimates and instrument-specific results may inform screening, but direct cross-instrument comparisons require caution.