Abstract
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.
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