Influence of depression on survival of colorectal cancer patients drawn from a large prospective cohort Depression and survival in colorectal cancer patients
Menée en Espagne auprès de 2 602 patients atteints d'un cancer colorectal, cette étude de cohorte prospective analyse l'association entre des symptômes de dépression et la survie, 5 ans après le diagnostic
Objective : The prevalence of depressive symptoms immediately after the diagnosis of colorectal cancer (CRC) is high and has important implications both psychologically and on the course of the disease. The aim of this study is to analyse the association between depressive symptoms and CRC survival at five years after diagnosis. Methods : This multicentre, prospective, observational cohort study was conducted on a sample of 2,602 patients with CRC who completed the Hospital Anxiety and Depression Scale (HADS-D) at five years of follow-up. Survival was analysed using the Kaplan-Meier method and Cox regression models. Results : According to our analysis, the prevalence of depressive symptoms after a CRC diagnosis was 23.8%. The Cox regression analysis identified depression as an independent risk factor for survival (HR=1.47; 95% CI: 1.21-1.8), a finding which persisted after adjusting for sex (female: HR=0.63; 95%CI: 0.51–0.76), age (>70 years: HR=3.78; 95%CI: 1.94–7.36), need for help (yes: HR=1.43; 95%CI: 1.17–1.74), provision of social assistance (yes: HR=1.46; 95%CI: 1.16–1.82), tumour size (T3-T4: HR=1.56; 95%CI: 1.22–1.99), nodule staging (N1-N2: HR=2.46; 95%CI: 2.04–2.96), and diagnosis during a screening test (yes: HR=0.71; 95%CI: 0.55–0.91). Conclusions : There is a high prevalence of depressive symptoms in patients diagnosed with CRC. These symptoms were negatively associated with the survival rate independently of other clinical variables. Therefore, patients diagnosed with CRC should be screened for depressive symptoms to ensure appropriate treatment can be provided.
Psycho-Oncology 2022