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The primary aim of this subject- wide systematic review was to collate and synthesize evidence on doping prevalence from published scientific papers. Secondary aims involved reviewing the reporting accuracy and data quality as evidence for doping behavior to (1) develop quality and bias assessment criteria to facilitate future systematic reviews; and (2) establish recommendations for reporting future research on doping behavior in competitive sports to facilitate better meta-analyses of doping behavior. Using PRISMA guidelines, 105 studies, published between 1975 and 2019, were included. To determine prevalence, the majority (89/205 studies) used self-reported surveys. Doping prevalence rates in competitive sport ranged from 0% to 73% for doping behavior with most falling under 5%. Inconsistencies in data reporting prevented meta-analysis for sport, gender, region, or competition level. Qualitative syntheses were possible and provided for study type, gender, and geographical region. Current knowledge about doping prevalence in competitive sport relies upon weak and disparate evidence. To address this, we offer a comprehensive set of assessment criteria for studies examining doping behavior data as evidence for doping prevalence. To facilitate future evidence syntheses and meta-analyses, we also put forward “best practice” recommendations and reporting guidelines that will improve evidence quality.

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