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Prevalence and determinants of depression up to 5 years after colorectal cancer surgery : results from the ColoREctal Wellbeing (CREW) study
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Calman, Lynn, Turner, Joshua, Fenlon, Deborah, Permyakova, Natalia V., Wheelwright, Sally, Patel, Mubarak, Din, Amy, Winter, Jane, Richardson, Alison, Smith, Peter W. F. and Foster, Claire (2021) Prevalence and determinants of depression up to 5 years after colorectal cancer surgery : results from the ColoREctal Wellbeing (CREW) study. Colorectal Disease, 23 (12). pp. 3234-3250. doi:10.1111/codi.15949
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Official URL: https://doi.org/10.1111/codi.15949
Abstract
Aim: Depression experienced by people with colorectal cancer (CRC) is an important clinical problem affecting quality of life. Recognition of depression at key points in the pathway enables timely referral to support. This study aimed to examine depression before and 5 years after surgery to examine its prevalence and identify determinants.
Method: The ColoREctal Wellbeing (CREW) study is a prospective UK cohort study involving 872 adults with nonmetastatic CRC recruited before surgery with curative intent. Questionnaires completed before surgery and 3, 9, 15, 24, 36, 48 and 60 months after surgery captured socio‐demographics and assessed depression (Centre for Epidemiologic Studies Depression Scale, CES‐D) and other psychosocial factors. Clinical details were also gathered. We present the prevalence of clinically significant depression (CES‐D ≥ 20) over time and its predictors assessed before and 2 years after surgery.
Results: Before surgery, 21.0% of the cohort reported CES‐D ≥ 20 reducing to 14.7% 5 years after surgery. Presurgery risk factors predicting subsequent depression were clinically significant depression and anxiety, previous mental health service use, low self‐efficacy, poor health, having neoadjuvant treatment and low social support. Postsurgery risk factors at 2 years predicting subsequent depression were clinically significant depression, negative affect, cognitive dysfunction, accommodation type and poor health.
Conclusion: Depression is highly pervasive in people with CRC, exceeding prevalence in the general population across follow‐up. Our findings emphasize the need to screen and treat depression across the pathway. Our novel data highlight key risk factors of later depression at important and opportune time points: before surgery and at the end of routine surveillance. Early recognition and timely referral to appropriate support is vital to improve long‐term psychological outcomes.
| Item Type: | Journal Article | |||||||||||||||||||||||||||||||||||||||||||||||||||
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| Alternative Title: | Prevalence and determinants of depression up to five years after colorectal cancer surgery | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Subjects: | R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer) R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | |||||||||||||||||||||||||||||||||||||||||||||||||||
| SWORD Depositor: | Library Publications Router | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Library of Congress Subject Headings (LCSH): | Colon (Anatomy) -- Cancer -- Patients -- Psychology, Colon (Anatomy) -- Cancer -- Psychological aspects, Rectum -- Cancer -- Patients -- Psychology, Rectum -- Cancer -- Psychological aspects, Depression, Mental -- Etiology | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Journal or Publication Title: | Colorectal Disease | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Publisher: | Wiley-Blackwell Publishing, Inc. | |||||||||||||||||||||||||||||||||||||||||||||||||||
| ISSN: | 1462-8910 | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Official Date: | December 2021 | |||||||||||||||||||||||||||||||||||||||||||||||||||
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| Volume: | 23 | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Number: | 12 | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Page Range: | pp. 3234-3250 | |||||||||||||||||||||||||||||||||||||||||||||||||||
| DOI: | 10.1111/codi.15949 | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Status: | Peer Reviewed | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Publication Status: | Published | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Access rights to Published version: | Open Access | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Copyright Holders: | © 2021 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland | |||||||||||||||||||||||||||||||||||||||||||||||||||
| RIOXX Funder/Project Grant: |
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