Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Jan-Dec:23:15347354241293449.
doi: 10.1177/15347354241293449.

The Efficacy of Internet-Based Cognitive Behavioral Therapy for Patients With Breast Cancer: A Systematic Review and Meta-Analysis

Lihong Yang  1 , Shujie Hao  2 , Dongying Tu  1 , Xiaolian Gu  1 , Chunyan Chai  1 , Huan Ding  1 , Bin Gu  1 , Xuefang Yang  1
Affiliations
Meta-Analysis

The Efficacy of Internet-Based Cognitive Behavioral Therapy for Patients With Breast Cancer: A Systematic Review and Meta-Analysis

Lihong Yang et al. Integr Cancer Ther. 2024 Jan-Dec.

Abstract

Objective: To systematically review and analyze the effects of Internet-based cognitive behavioral therapy (ICBT) on physical, psychological, and daily life outcomes in patients with breast cancer.

Methods: Relevant studies were retrieved from Wanfang, CBM, CNKI, CINAHL, PsycINFO, Web of Science, The Cochrane Central Register of Controlled Trials, Embase and PubMed from inception to December 2023. Two independent authors conducted the literature search and data extraction. The Cochrane bias risk assessment tool was used to evaluate the included studies for methodological quality, and the data analysis was performed using Stata (Version 15.0).

Results: Among 700 records, 11 randomized controlled trials were identified in this study. The meta-analysis showed statistically significant effects of ICBT on depression (standardized mean difference (SMD) = -0.38, 95% confidence interval (CI): -0.70 to -0.06, P = .019) and insomnia severity (SMD = -0.71, 95% CI: -1.24 to -0.19, P = .008). However, there were no statistically significant effects on anxiety, fatigue, sleep quality and quality of life.

Conclusions: ICBT appears to be effective for improving depression and reducing insomnia severity in patients with breast cancer, but the effects on anxiety, fatigue, sleep quality and quality of life are non-significant. This low-cost treatment needs to be further investigated. More randomized controlled trials with a larger sample size, strict study design and multiple follow-ups are required to determine the effects of ICBT on patients with breast cancer.

Keywords: Internet; breast neoplasm; cognitive behavioral therapy (CBT); meta-analysis; systematic review.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow diagram of literature selection.
Figure 2.
Figure 2.
Risk of bias assessment using the Cochrane tool: (A) individual trials; (B) overall trials.
Figure 3.
Figure 3.
Forest plot of the effectiveness of ICBT on: (A) anxiety, (B) depression, (C) fatigue, (D) insomnia severity, (E) sleep quality, and (F) quality of life.
Figure 4.
Figure 4.
Funnel plot on publication bias: (A) anxiety, (B) depression, (C) fatigue, (D) insomnia severity, (E) sleep quality, and (F) quality of life.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Sung H, Ferlay J, Siegel RL, et al.. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209-249. doi: 10.3322/caac.21660 - DOI - PubMed
    1. Arnold M, Morgan E, Rumgay H, et al.. Current and future burden of breast cancer: global statistics for 2020 and 2040. Breast. 2022;66:15-23. doi: 10.1016/j.breast.2022.08.010 - DOI - PMC - PubMed
    1. Rosenberg SM, Stanton AL, Petrie KJ, Partridge AH. Symptoms and symptom attribution among women on endocrine therapy for breast cancer. Oncologist. 2015;20:598-604. doi:10.1634/theoncologist.2015-0007 - DOI - PMC - PubMed
    1. Chappell AG, Bai J, Yuksel S, Ellis MF. Post-mastectomy pain syndrome: defining perioperative etiologies to guide new methods of prevention for plastic surgeons. World J Plast Surg. 2020;9:247-253. doi:10.29252/wjps.9.3.247 - DOI - PMC - PubMed
    1. Santen RJ, Stuenkel CA, Davis SR, et al.. Managing menopausal symptoms and associated clinical issues in breast cancer survivors. J Clin Endocrinol Metab. 2017;102:3647-3661. doi:10.1210/jc.2017-01138 - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources