Depression and anxiety in long-term survivors 5 and 10 years after cancer diagnosis

Support Care Cancer. 2020 Jan;28(1):211-220. doi: 10.1007/s00520-019-04805-1. Epub 2019 Apr 18.

Abstract

Purpose: Our study provides data on depression and anxiety in long-term cancer survivors, in men, women and various age groups, as well as identifies associated factors and coping-related resources.

Methods: We present data obtained from 1002 cancer survivors across a large variety of tumour entities 5 years (cohort 1) and 10 years (cohort 2) after diagnosis, in a cross-sectional study. We analysed depression (PHQ-9) and anxiety (GAD-7) symptomatology in comparison with two large age- and sex-matched samples randomly selected from the general population.

Results: Moderate to severe depression and anxiety were reported in 17% and 9% of cancer survivors, respectively. There were no significant differences between the 5 years and 10 years after diagnosis cohorts (p = 0.232). In both cohorts, we found higher depression and anxiety in women than in men (p < 0.001), and lower depression and anxiety in elderly patients (p < 0.001). Cancer survivors younger than 60 years of age were more depressed and anxious than the general population (p < 0.001). The variables, financial problems (Beta = 0.16, p < 0.001), global quality of life (Beta = - 0.21, p < 0.001) and cognitive function (Beta = - 0.30, p < 0.001), had the strongest association with depression and anxiety.

Conclusions: For the prevention of depression and anxiety in long-term cancer survivors, individual treatment of physical and psychological symptoms is as important as social support and professional counselling. Post-treatment, cognitive limitations should be carefully assessed in long-term cancer survivorship to distinguish them from symptoms of a mental disorder, especially since younger cancer survivors of working age and female survivors seem to be more affected by depression and anxiety.

Keywords: Anxiety; Cancer; Depression; Health services; Quality of life.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety / epidemiology*
  • Anxiety / etiology
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / etiology
  • Cancer Survivors / psychology
  • Cancer Survivors / statistics & numerical data*
  • Case-Control Studies
  • Cohort Studies
  • Cross-Sectional Studies
  • Depression / epidemiology*
  • Depression / etiology
  • Depressive Disorder / epidemiology
  • Depressive Disorder / etiology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / diagnosis
  • Neoplasms / epidemiology
  • Neoplasms / psychology
  • Quality of Life / psychology
  • Social Support
  • Young Adult