Background Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect in cancer patients, yet studies have reported inconsistent incidence and influencing factors for CIPN. This study aims to systematically evaluate the incidence and influencing factors of CIPN in cancer patients. Methods The search databases included PubMed, Embase, Cochrane Library, and Web of Science, focusing on CIPN incidence and influencing factors in cancer patients up to 10 June, 2025. A meta-analysis of incidence and influencing factors was performed separately by Stata 17.0 software. Results 23 studies involving a sample size of 15,090 cases were included, and 16 influencing factors were identified. The incidence of CIPN in cancer patients was 56% (95% CI: 46–66%, p 0.01). Age ≥50 years ( OR = 1.07, 95% CI: 1.03–1.10), BMI ≥ 24 kg/m 2 ( OR = 1.15, 95% CI: 1.06–1.24), BMI ≥ 30 kg/m 2 ( OR = 1.67, 95% CI: 1.43–1.95), anxiety or depression ( OR = 2.50, 95% CI: 1.20–5.20), hypertension ( OR = 1.98, 95% CI: 1.07–3.69), diabetes mellitus ( OR = 1.66, 95% CI: 1.29–2.13), cumulative dose of chemotherapy drugs ( OR = 2.52, 95% CI: 1.20–5.32), chemotherapy≥4 cycles ( OR = 1.21, 95% CI: 1.08–1.35), combination with taxane chemotherapy (per 10 mg/m 2 ) ( OR = 3.14, 95% CI: 1.81–5.44), vitamin D deficiency ( OR = 5.63, 95%CI: 2.64–11.99), high cholesterol ( OR = 1.34, 95% CI: 1.14–1.58), and transaminase elevation ( OR = 2.10, 95% CI: 1.55–2.84) were influencing factors for CIPN in cancer patients. Conclusion The results show that the incidence of CIPN in cancer patients is at a high level, and its influencing factors are varied and complex. This suggests that clinicians should screen for CIPN early to improve clinical outcomes and enhance the quality of life and survival for cancer patients. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/ , CRD420251010306.
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