title: 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.
authors.affiliation: Department of Organizational Psychology, Birkbeck, University of London, London, UK.
authors.forename: Asta
authors.identifier: http://orcid.org/0000-0002-0404-775X
authors.initials: A
authors.lastname: Medisauskaite
authors.affiliation: Department of Organizational Psychology, Birkbeck, University of London, London, UK.
authors.forename: Caroline
authors.initials: C
authors.lastname: Kamau
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology; D002055:Burnout, Professional / Q000523:psychology*; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008495:Medical Oncology; D009369:Neoplasms / Q000523:psychology; D000072103:Oncologists / Q000523:psychology / Q000706:statistics & numerical data*; D015995:Prevalence; D011446:Prospective Studies; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D016526:Workload
keywords: burnout; cancer; meta-analysis; oncology; psychiatric morbidity; sleep; stress