Psychological Distress in Bladder Cancer Patients: A Systematic Review

ABSTRACT Objective Bladder cancer patients experience high levels of disease and treatment‐related distress, however, factors that can mitigate patient‐reported psychological distress are poorly characterized. Thus, this study serves to summarize the burden of psychological distress among bladder cancer patients and identify clinical, psychological, and socioeconomic factors that are associated with varying levels of psychological distress. Methods We performed a systematic review of studies examining psychological distress in bladder cancer patients. We searched PubMed/MEDLINE, Embase, and PsycINFO from October 2000 to February 2024 according to the PRISMA guidelines. Associations between clinical, psychological, socioeconomic factors, and psychological distress were identified in each study and extracted. The protocol for this review is registered in PROSPERO (CRD42024495568). Results Using our search strategy, 759 articles were retrieved and 17 met inclusion criteria, representing 2572 bladder cancer patients. Tumor stage (n = 3), younger age (n = 2), female sex (n = 2) the preoperative setting (n = 2), depression/anxiety (n = 2), and negative psychological response to illness (n = 2) were common factors associated with increased psychological distress. Transitioning from the preoperative to the postoperative period (n = 2), postoperative inpatient rehabilitation (n = 2), feeling well informed (n = 2), and social support (n = 2) were associated with decreased psychological distress. Conclusion While clinical factors associated with increased psychological distress are nonmodifiable, clinical, psychological, and socioeconomic factors associated with decreased psychological distress can be improved upon by healthcare providers to mitigate the distress that bladder cancer patients experience. This systematic review summarizes the burden of psychological distress among bladder cancer patients and identifies associated clinical, psychological, and socioeconomic factors. We found that advanced tumor stage, younger age, female gender, preoperative settings, depression/anxiety, and negative psychological responses increase distress, while transitioning to postoperative care, postoperative rehabilitation, feeling well‐informed, and social support mitigate it.