Prevalence of oncologists in distress: Systematic review and meta-analysis

Abstract

Objective: High mortality from cancer and rising patient numbers can trigger distress among oncologists because of a heavy and emotionally demanding workload. This systematic review and meta-analysis assesses the prevalence of high levels of distress among oncologists.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol is registered at the PROSPERO international prospective register (ref. 2015:CRD42015016325). We categorised data items according to the following distress factors: burnout, psychiatric morbidity, stress, depression, disrupted sleep, stress-induced physical symptoms, and substance use. We meta-analysed the prevalence of burnout and psychiatric morbidity using random effects models with MetaXL software.

Results: The meta-analyses showed that 32% of 4876 oncologists had high burnout (±CI 28%-36%) and 27% of 2384 had high psychiatric morbidity (±CI 23%-32%). Studies also showed that 42% to 69% feel stressed at work, >12% of oncologists screen positive for depression, many oncologists suffer from sleep deprivation, up to 30% drink alcohol in a problematic way, and up to 20% of junior oncologists use hypnotic drugs, and some frequently experience stress-induced complaints such as ulcers, gastric problems, headaches, and arrhythmia.

Conclusions: Occupational distress reduces career satisfaction, affects patient care, and increases the chances of oncologists switching to another area of medicine; therefore, future research should explore appropriate interventions.

Keywords: burnout; cancer; meta-analysis; oncology; psychiatric morbidity; sleep; stress.