The researchers searched multidisciplinary health, psychology and other academic databases for observational studies that reported validated measures of anxiety or depression among family caregivers of children with cancer. They supplemented the database searches with grey literature. Data extraction and risk-of-bias assessments using the Joanna Briggs Institute tool were completed independently by multiple reviewers.

The search identified 2,089 records, and 30 studies met the eligibility criteria for the systematic review and meta-analysis. Single-proportion random-effects meta-analyses were used to estimate pooled prevalence, while subgroup analyses and meta-regressions examined variation in the results. Most included studies were cross-sectional, and most were conducted in North America or Europe.

Statistical heterogeneity was extremely high, with the I-squared statistic exceeding 95% in the main analyses, showing that prevalence estimates varied markedly among the underlying studies. Meta-regressions found no associations between prevalence and caregiver age, the age or sex distribution of children with cancer, or the prevalence of leukemia. Anxiety estimates were higher in subgroup analyses of studies conducted in Asia and Europe and among studies using combined assessment tools.

No significant subgroup differences were found for depressive symptoms. These comparisons describe patterns across included studies rather than changes over time or demonstrated differences between populations. Risk-of-bias assessments identified considerable methodological limitations in the included studies, particularly concerning sampling and reporting.

The authors therefore cautioned that the pooled estimates should be interpreted in light of the substantial between-study variability. Despite these limitations, the combined results indicate that anxiety and depressive symptoms occur in a substantial minority of the caregivers studied. The researchers emphasized that care strategies for children with cancer should include family members and address their mental-health needs throughout the cancer treatment process.

Subject of Research: Pooled prevalence of anxiety and depressive symptoms among family caregivers of children with cancer

Article Title: Prevalence of psychological distress among family caregivers of children with cancer: a systematic review and meta-analysis

Article References: Dias de Jesus, E. E., Carminatti, M., Bastos Matos Schlichting, J., Sudatti Delevatti, R., Lopez, P., & de la Rocha Freitas, C. (2026). Prevalence of psychological distress among family caregivers of children with cancer: a systematic review and meta-analysis. BMC Psychology. https://doi.org/10.1186/s40359-026-05321-8

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05321-8

Keywords: childhood cancer, family caregivers, anxiety, depression, psychological distress, systematic review, meta-analysis, prevalence, observational studies, pediatric oncology, psychological, distress