Are long-term cancer survivors still at increased risk of depression?

Wen-Kuan Huang | okt 2019 | Onkologi /hematologi |

Wen-Kuan Huang
Department of Oncology-Pathology,
Karolinska Institute, Stockholm and
Division of Hematology-Oncology,
Linkou Chang Gung Memorial Hospital,
Taoyuan, Taiwan

Shu-Hao Chang
Division of Hematology-Oncology,
Linkou Chang Gung Memorial Hospital,
Taoyuan, Taiwan

Li-Chu See
Division of Hematology-Oncology,
Linkou Chang Gung Memorial Hospital,
Taoyuan, Taiwan

Given the spread of cancer screening programs and advances of treatments, the lifespan of adult patients with cancers increases over the recent decade. Two-thirds of patients are long-term cancer survivors (LTCS), which is defined as being alive for more than five years after diagnosis.1  The mental health of cancer survivorship has become an increasingly important issue. Little is known about the risk of depression among LTCS due to small sample size or restriction to specific cancer type. Recently a population-based cohort study using Taiwan national health insurance research database investigated the timing and risk factors of depression in LTCS.2 Demographic statistics of this study Between 2000 and 2007, 190,748 patients with newly diagnosed cancers and survival at least 5 years after diagnosis were identified as the LTCS group. A control group from general population was 1:1 matched by sex, age, and Charlson comorbidities index score (CCI score). The median follow-up time was approxi-mately eight years (8.13 years in the LTCS group vs. 8.49 years in the control group, respec-tively). The five most common cancer types of LTCS were breast cancer (20%), followed by colorectal cancer (15.3%), head and neck cancer (13%), cancer of uterus (9.3%) and hepatobiliary cancer (5.8%). Eighty-six percent of patients received at least one of three main anti-cancer treatments including surgery, radiation and systemic chemotherapy/hormone therapy. Risk of depression among long-term cancer survivors During the follow-up period, long-term survivors had a significantly 13% higher risk of depression than matched general population (8.38 vs. 7.21 per 1,000 person-years). In terms of cancer types, patients with head and neck cancer (HNC), nasopharyngeal cancer (NPC), esophageal cancer, gastric cancer, lung cancer, breast cancer, bladder cancer, prostate cancer and brain cancer were at increased risk after ad-justing for urbanization and income level.  Notably, LTCS with HNC and esophageal cancer were associated with...