Depressive and anxiety symptoms among Japanese cancer survivors: Japan cancer survivorship research project

Motoki Endo,Kiyomi Mitsui,Satoru Takeda,Rie Akaho,Kazuhiko Hayashi,Katsuji Nishimura,Mitsue Saito,Kentaro Matsui,Gautam A Deshpande,Yasuhisa Terao,Yan Yan,Yuito Ueda,Takeshi Tanigawa,Go Muto,Yuya Imai

doi:10.1186/s12885-022-09215-x

Abstract

BackgroundThis study aimed to clarify predictors of depressive symptoms and anxiety symptoms after cancer diagnosis among Japanese cancer survivors (CSs).MethodsAs part of a Japanese cancer survivorship research project commissioned by the Ministry of Health, Labour and Welfare (MHLW) of Japan, we conducted a web-based nationwide survey of CSs in 2018. We analyzed the risk factors for depressive and anxiety symptoms, as measured by the Hospital Anxiety and Depression Scale Japanese version (HADS).ResultsOf 1,234 Japanese CSs, mean score of HADS-depression and HADS-anxiety were 4.08 and 4.78, respectively. At the time of the study, the number of CSs with symptoms of depression and anxiety were 111 (9.0%) and 269 (21.8%), respectively. After multivariable analysis, CSs ≥ 60 years old (reference: ≤ 39 years old, odds ratios (OR): 0.39, 95%CI: 0.17–0.90) and those ≥ 10 years from cancer diagnosis (reference: 0–4 years, OR: 0.55, 95%CI: 0.32–0.96) had lower odds for depressive symptoms. And CSs ≥ 60 years old (reference: ≤ 39 years old, OR: 0.27, 95%CI: 0.15–0.49) and those ≥ 10 years from cancer diagnosis (reference: 0–4 years, OR: 0.62, 95%CI: 0.42–0.90) also had lower odds for anxiety symptoms. CSs who received chemotherapy (OR: 1.56, 95%CI: 1.10–2.20) had higher odds for anxiety symptoms.ConclusionsBased on manifestation of symptoms, CSs who were younger, closer to the time of cancer diagnosis, had advanced-staged cancer, or received chemotherapy may be at higher risk for depressive or anxiety symptoms. Those CSs who have higher risk for depression and anxiety symptoms, should be followed-up more carefully for better cancer survivorship, by medical professionals, companies, and society.

Highlights

This study aimed to clarify predictors of depressive symptoms and anxiety symptoms after cancer diagnosis among Japanese cancer survivors (CSs)
Of the 1,610 respondents, we excluded the following participants: 192 who were diagnosed with cancer for the first time before 2000; 107 who had a psychiatric diagnosis prior to cancer diagnosis (n = 107); 60 who had more than two kinds of cancers; and 17 for whom no cancer data were available
Breast cancer survivors were most represented in the sample (n = 230, 18.6%), followed by intestinal CSs (n = 199), which included colorectal cancer (n = 191, 16.1%), small intestine cancer (n = 4, 0.3%), and appendix cancer (n = 4, 0.3%)

Summary

Introduction

This study aimed to clarify predictors of depressive symptoms and anxiety symptoms after cancer diagnosis among Japanese cancer survivors (CSs). Mitchell’s meta-analysis reported that prevalence of self-reported depression and anxiety among approximately 50,000 CSs from developed countries as about 12% and 18%, respectively [4]. World Mental Health Japan Survey reported in 2016 that 12-month prevalence of mood disorders and anxiety disorders in Japanese general populations was 2.3%, and 4.9%, respectively[5]. Both depressive and anxiety symptoms have been reported to have profoundly negative effects on CSs, including reduced quality of life and greater rates of suicide [6]. Routine screening instruments like the Hospital Anxiety and Depression Scale (HADS) may be useful tools to facilitate the early detection of depression or anxiety among

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