Psychological problems among cancer patients in relation to healthcare and societal costs: A systematic review: A systematic review

Florie E. van Beek, Lonneke M. A. Wijnhoven, Karen Holtmaat, José A. E. Custers, Judith B. Prins, Irma M. Verdonck-de Leeuw, Femke Jansen

Research output: Contribution to journalReview articleAcademicpeer-review

11 Citations (Scopus)


Objective: This study systematically reviewed the association of psychological problems among cancer patients with healthcare and societal resource use and costs. Methods: PubMed, PsycINFO, and Embase were searched (until 31 January 2021) for studies on psychological symptoms (anxiety, depression, distress, fear of recurrence) or psychiatric disorders (anxiety, depression, adjustment) and healthcare use (e.g., mental, inpatient healthcare), economic losses by patients and family, economic losses in other sectors (e.g., absence from work), and costs. The search, data extraction, and quality assessment were performed by two authors. Results: Of the 4157 identified records, 49 articles were included (psychological symptoms (n = 34), psychiatric disorders (n = 14), both (n = 1)) which focused on healthcare use (n = 36), economic losses by patients and family (n = 5), economic losses in other sectors (n = 8) and/or costs (n = 13). In total, for 12 of the 94 associations strong evidence was found. Psychological symptoms and psychiatric disorders were positively associated with increased healthcare use (mental, primary, inpatient, outpatient healthcare), losses in other sectors (absence from work), and costs (inpatient, outpatient, total healthcare costs). Moderate evidence was found for a positive association between (any) psychiatric disorder and depression disorder with inpatient healthcare and medication use, respectively. Conclusions: Psychological problems in cancer patients are associated with increased healthcare use, healthcare costs and economic losses. Further research is needed on psychological problems in relation to understudied healthcare use or costs categories, productivity losses, and informal care costs.
Original languageEnglish
Pages (from-to)1801-1835
Number of pages35
Issue number11
Early online date2021
Publication statusPublished - 1 Nov 2021


  • cancer
  • costs
  • healthcare use
  • oncology
  • psychiatric disorder
  • psychological symptom
  • work productivity

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