Abstract
Simple SummaryDepression is a common disorder in cancer patients. In this population-based prospective cohort study, we investigated if patients with colorectal cancer experience a higher risk of pharmacological or hospital treatment for depression than age- and gender-matched cancer-free comparison persons when differences in lifestyle, anthropometry, socioeconomic position or comorbidity where taken into account. To identify potential risk factors, we further investigated the associations between depression and antidepressant use and pre-cancer lifestyle factors, clinical factors and treatment factors. The study results may help point toward vulnerable groups of patients at risk of depression.We investigated the risk of depression in colorectal cancer (CRC) patients and associated risk factors. The 1324 patients with CRC and 6620 matched cancer-free participants from the Diet, Cancer and Health study were followed for up to 16 years for either a first hospitalization for depression or antidepressant prescription after diagnosis of CRC cancer or study entry date. Information on the outcome and covariates was retrieved from the Danish Colorectal Cancer Group database, the national health registries and questionnaires. Cumulative incidence of depression was estimated, and Cox regression models were used to evaluate the association between risk factors and depression incidence. During follow-up, 191 (14.4%) patients with CRC and 175 (2.6%) cancer-free comparison persons experienced depression. After adjustments, in the first year after cancer diagnosis, patients with CRC had a 12-fold higher hazard compared with the cancer-free population (HR, 12.01; 95% CI, 7.89–18.28). The risk decreased during follow-up but remained significantly elevated with an HR of 2.65 (95% CI, 1.61–4.36) after five years. Identified risk factors were presence of comorbidities, advanced disease stage and use of radiotherapy, while life style factors (pre-cancer or at diagnosis) and chemotherapy did not seem to contribute to the increased risk.
Highlights
Due to the enhanced screening and prevention efforts and improved treatments in high-income countries, the mortality rates for colorectal cancer (CRC) have decreased [1].Survivors after colorectal cancer often suffer from late effects from the cancer and its treatments [2,3] that may affect their wellbeing and quality of life [4,5].The physical late effects of CRC and its treatments are well known and include among other things gastrointestinal and urogenital problems [6], sexual dysfunction [7]and neuropathy [8,9]
The distribution of sociodemographic and lifestyle characteristics was similar among patients with CRC and cancer-free comparison persons except that more patients with CRC were current smokers and had comorbidity at entry (Table 1)
The cumulative incidence for depression was 15.4% for patients with CRC compared with 2.3%
Summary
Due to the enhanced screening and prevention efforts and improved treatments in high-income countries, the mortality rates for colorectal cancer (CRC) have decreased [1].Survivors after colorectal cancer often suffer from late effects from the cancer and its treatments [2,3] that may affect their wellbeing and quality of life [4,5].The physical late effects of CRC and its treatments are well known and include among other things gastrointestinal and urogenital problems [6], sexual dysfunction [7]and neuropathy [8,9]. Due to the enhanced screening and prevention efforts and improved treatments in high-income countries, the mortality rates for colorectal cancer (CRC) have decreased [1]. Survivors after colorectal cancer often suffer from late effects from the cancer and its treatments [2,3] that may affect their wellbeing and quality of life [4,5]. The physical late effects of CRC and its treatments are well known and include among other things gastrointestinal and urogenital problems [6], sexual dysfunction [7]. Neuropathy [8,9] This group of patients may live with a colostomy as a result of the surgical intervention, giving rise to specific problems. Emotional and psychological late effects such as fear of recurrence, negative body image, anxiety and depression have been reported in a few previous reports [2,3], but research is limited [10].
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
