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      The efficacy of internet-based cognitive behavior therapy for psychological health and quality of life among breast cancer patients: a systematic review and meta-analysis

      systematic-review

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          Abstract

          Objective

          To systematically investigate the effect of Internet-based cognitive-behavioral therapy (ICBT) on depression, anxiety, fatigue and quality of life (QOL) in patients with breast cancer (BC).

          Methods

          A systematic review with meta-analysis and qualitative evidence synthesis was performed. Ten databases, including PubMed, Web of Science, EMBASE, the Cochrane Library, CINAHL, JBI Chinese Biomedical database (CBM), China National Knowledge Infrastructure (CNKI), VIP, and Wanfang, were searched from the start till August 2023. Published studies in English or Chinese were eligible for randomized and clinical controlled trials determining the efficacy of ICBT among BC survivors. The quality of the evidence was evaluated at the study level and the outcome level.

          Results

          In total, 11 clinical trials on 1,307 patients with BC (ICBT: 671, control: 636) were systematically reviewed. We found that ICBT is effective in alleviating psychological distress in BC survivors, and the quality of all studies was moderate. The meta-analysis indicated that ICBT affected primary outcomes of anxiety (standardized mean difference [SMD] = −0.71, 95% confidence interval [CI]: −1.19, −0.24, p < 0.0001), depression (SMD = −0.67, 95% CI: −1.07, −0.27, p < 0.0001), fatigue (SMD = −1.23, 95% CI: −2.37, −0.08, p < 0.0001) and QOL (SMD = 0.79, 95% CI: 0.21, 1.37, p < 0.00001).

          Conclusion

          This meta-analysis indicates that ICBT, as a type of psychosocial rehabilitation, can mitigate the incidence of depression, anxiety, and fatigue and improve the quality of life among patients with BC. Nevertheless, the effect is not distinct, and multi-centered randomized controlled trials with larger cohorts are warranted to verify the effectiveness of ICBT.

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          Most cited references41

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          Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
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            Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions

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              Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation.

              Protocols of systematic reviews and meta-analyses allow for planning and documentation of review methods, act as a guard against arbitrary decision making during review conduct, enable readers to assess for the presence of selective reporting against completed reviews, and, when made publicly available, reduce duplication of efforts and potentially prompt collaboration. Evidence documenting the existence of selective reporting and excessive duplication of reviews on the same or similar topics is accumulating and many calls have been made in support of the documentation and public availability of review protocols. Several efforts have emerged in recent years to rectify these problems, including development of an international register for prospective reviews (PROSPERO) and launch of the first open access journal dedicated to the exclusive publication of systematic review products, including protocols (BioMed Central's Systematic Reviews). Furthering these efforts and building on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, an international group of experts has created a guideline to improve the transparency, accuracy, completeness, and frequency of documented systematic review and meta-analysis protocols--PRISMA-P (for protocols) 2015. The PRISMA-P checklist contains 17 items considered to be essential and minimum components of a systematic review or meta-analysis protocol.This PRISMA-P 2015 Explanation and Elaboration paper provides readers with a full understanding of and evidence about the necessity of each item as well as a model example from an existing published protocol. This paper should be read together with the PRISMA-P 2015 statement. Systematic review authors and assessors are strongly encouraged to make use of PRISMA-P when drafting and appraising review protocols. © BMJ Publishing Group Ltd 2014.
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                Author and article information

                Contributors
                URI : https://loop.frontiersin.org/people/2830455/overviewRole: Role:
                Role: Role: Role:
                Role: Role: Role:
                Role: Role: Role:
                Role: Role: Role:
                Journal
                Front Psychol
                Front Psychol
                Front. Psychol.
                Frontiers in Psychology
                Frontiers Media S.A.
                1664-1078
                08 January 2025
                2024
                : 15
                : 1488586
                Affiliations
                [1] 1Northern Jiangsu People's Hospital, Yangzhou University , Yangzhou, China
                [2] 2Jiangsu Cancer Hospital, Nanjing Medical University , Nanjing, Jiangsu, China
                Author notes

                Edited by: Tamkeen Saleem, Shifa Tameer-e-Millat University, Pakistan

                Reviewed by: Valentina Tesio, University of Turin, Italy

                Luisa Orru’, University of Padua, Italy

                *Correspondence: Yin Ping, 673488894@ 123456qq.com
                Article
                10.3389/fpsyg.2024.1488586
                11750816
                39845542
                3f5f36b9-efb1-4f9f-b128-8831541b4b13
                Copyright © 2025 Lin, Ping, Jing, Xu and Ping.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 30 August 2024
                : 23 December 2024
                Page count
                Figures: 7, Tables: 1, Equations: 0, References: 41, Pages: 10, Words: 6192
                Funding
                The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study was supported by the Hospital Foundation of Northern Jiangsu People’s Hospital (SBHL23006).
                Categories
                Psychology
                Systematic Review
                Custom metadata
                Psycho-Oncology

                Clinical Psychology & Psychiatry
                internet,cognitive behavior therapy,mental health,quality of life,breast cancer,systematic review,meta-analysis

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