The longitudinal changes of anxiety and depression, their related risk factors and prognostic value in colorectal cancer survivors: a 36-month follow-up study

Objective: This study was to investigate the longitudinal change of post-operative anxiety and depression, their related risk factors and prognostic value in colorectal cancer (CRC) patients after resection. Methods: Totally, 302 CRC patients who underwent resection were consecutively recruited. Their anxiety and depression were assessed by hospital anxiety and depression scale (HADS) at Month 0 (M0) and then every 3 months till Month 36 (M36). Results: Within 36-month follow-up period, HADS-A score (from 8.3 +/- 3.3 at M0 to 8.8 +/- 3.4 at M36, P = 0.179) exhibited an upward trend with time but without statistical significance; while anxiety rate (from 46.4% at M0 to 52.6% at M36, P = 0.019) was increased steadily with time longitudinally. Meanwhile, both HADS-D score (from 7.4 +/- 3.0 at M0 to 9.2 +/- 3.5 at M36, P < 0.001) and depression rate (from 33.8% at M0 to 57.9% at M36, P < 0.001) were elevated greatly with time longitudinally. Furthermore, multivariate logistic regression revealed that female and tumor size (>= 5 cm) were common independent risk factors for baseline/1-year/2-year/3-year anxiety (all P < 0.05); meanwhile, female, marry status (single/divorced/widowed vs. married) and advanced TNM stage were common independent risk factors for baseline/1-year/2-year/3year depression (all P < 0.05). As for new-onset anxiety and depression, no independent factor associated with new-onset anxiety was observed; meanwhile, female and TNM stage were independent risk factors for new-onset depression (both P < 0.05). Additionally, baseline/1-year anxiety and baseline/1-year/2-year/3-year depression were associated with lower accumulating OS (all P < 0.05). Conclusion: Post-operative anxiety and depression are highly prevalent and continuously progress, which also correlate with worse survival prognosis in CRC patients. (c) 2020 Elsevier Masson SAS. All rights reserved.