Abstract
Objective: The objective of the study is to investigate the relation between pretreatment depressive symptoms (DS) and the course of DS during the first year after cancer diagnosis, and overall survival among people with head and neck cancer (HNC). Methods: Data from the Head and Neck 5000 prospective clinical cohort study were used. Depressive symptoms were measured using the Hospital Anxiety and Depression Scale (HADS) pretreatment, at 4 and 12-month follow-up. Also, socio-demographic, clinical, lifestyle, and mortality data were collected. The association between before start of treatment DS (HADS-depression > 7) and course (never DS, recovered from DS, or persistent/recurrent/late DS at 12-month follow-up) and survival was investigated using Cox regression. Unadjusted and adjusted analyses were performed. Results: In total, 384 of the 2144 persons (18%) reported pretreatment DS. Regarding DS course, 63% never had DS, 16% recovered, and 20% had persistent/recurrent/late DS. People with pretreatment DS had a higher risk of earlier death than people without DS (hazard ratio (HR) = 1.65; 95% confidence interval (CI) 1.33-2.05), but this decreased after correcting for socio-demographic, clinical, and lifestyle-related factors (HR = 1.21; 95% CI 0.97-1.52). Regarding the course of DS, people with persistent/recurrent/late DS had a higher risk of earlier death (HR = 2.04; 95% CI 1.36-3.05), while people who recovered had a comparable risk (HR = 1.12; 95% CI 0.66-1.90) as the reference group who never experienced DS. After correcting for socio-demographic and clinical factors, people with persistent/recurrent/late DS still had a higher risk of earlier death (HR = 1.66; 95% CI 1.09-2.53). Conclusions: Pretreatment DS and persistent/recurrent/late DS were associated with worse survival among people with HNC.
Original language | English |
---|---|
Pages (from-to) | 2245-2256 |
Number of pages | 12 |
Journal | Psycho-Oncology |
Volume | 27 |
Issue number | 9 |
Early online date | 21 Jun 2018 |
DOIs | |
Publication status | Published - Sept 2018 |
Funding
4National Institute for Health Research (NIHR) Bristol Biomedical Research Centre, the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK KWF Kankerbestrijding, Grant/Award Num ber: VU 2013‐5930; National Institute for Health Research (NIHR) under its Programme Grants for Applied Research, Grant/Award Number: RP‐PG‐0707‐10034; Cancer Research UK Programme, Grant/Award Number: C18281/A19169 The study was funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RP‐PG‐0707‐10034). The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. Human papillomavirus serology was supported by a Cancer Research UK Programme Grant, the Integrative Cancer Epidemiology Programme (grant number: C18281/A19169). Funding for the survival analyses was obtained from the KWF Kankerbestrijding (grant number: VU 2013‐5930).
Funders | Funder number |
---|---|
Cancer Research UK Programme | C18281/A19169 |
Integrative Cancer Epidemiology Programme | |
National Institute for Health Research | RP‐PG‐0707‐10034 |
Cancer Research UK | |
KWF Kankerbestrijding | VU 2013‐5930 |
Keywords
- cancer
- depression
- depressive symptoms
- head and neck cancer
- mortality
- oncology
- survival