Prevalence and determinants of depression up to 5 years after colorectal cancer surgery: results from the ColoREctal Wellbeing (CREW) study
Prevalence and determinants of depression up to 5 years after colorectal cancer surgery: results from the ColoREctal Wellbeing (CREW) study
Aim: depression experienced by people with colorectal cancer (CRC) is an important clinical problem affecting quality of life. Recognition at key points in the pathway enables timely referral to support. This study aimed to examine depression pre- and 5 years post-surgery to examine its prevalence and identify determinants.
Methods: the ColoREctal Wellbeing (CREW) study is a prospective UK cohort involving 872 adults with non-metastatic CRC recruited before curative-intent surgery. Questionnaires completed pre-surgery, and 3, 9, 15, 24, 36, 48 and 60 months post-surgery, captured socio-demographics, assessed depression (Centre for Epidemiologic Studies Depression Scale, CES-D) and other psychosocial factors. Clinical details were also gathered. We present prevalence of clinically significant depression (CES-D≥20) over time and its predictors assessed pre-surgery and 2 years post-surgery.
Results: pre-surgery, 21.0% of the cohort reported CES-D≥20 reducing to 14.7% 5 years post-surgery. Pre-surgery risk factors predicting subsequent depression: clinically significant depression and anxiety, previous mental health service use, low self-efficacy, poor health, having neoadjuvant treatment and low social support. Post-surgery risk factors at 2 years predicting subsequent depression: clinically significant depression, negative affect, cognitive dysfunction, accommodation type and poor health.
Conclusions: depression is highly pervasive in people with CRC, exceeding general population prevalence across follow-up. Our findings emphasise the need to screen and treat depression across the pathway. Our novel data highlights key risk factors of later depression at important and opportune timepoints: pre-surgery and the end of routine surveillance. Early recognition and timely referral to appropriate support is vital to improve long-term psychological outcomes.
Calman, Lynn
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Turner, Joshua
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Fenlon, Deborah R
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Permyakova, Natalia Vadimovna
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Wheelwright, Sally
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Patel, Mubarak I
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Din, Amy
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Winter, Jane
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Richardson, Alison
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Smith, Peter W.F.
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Foster, Claire
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25 November 2021
Calman, Lynn
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Turner, Joshua
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Fenlon, Deborah R
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Permyakova, Natalia Vadimovna
27793eb1-9b3d-4194-8e80-8d0d4c0798ea
Wheelwright, Sally
2df90681-fb0a-4871-ae7d-75c88b35024b
Patel, Mubarak I
30758f65-2c04-4d9b-b54f-564f3ba50509
Din, Amy
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Winter, Jane
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Richardson, Alison
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Smith, Peter W.F.
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Foster, Claire
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Calman, Lynn, Turner, Joshua, Fenlon, Deborah R, Permyakova, Natalia Vadimovna, Wheelwright, Sally, Patel, Mubarak I, 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.
(doi:10.1111/codi.15949).
Abstract
Aim: depression experienced by people with colorectal cancer (CRC) is an important clinical problem affecting quality of life. Recognition at key points in the pathway enables timely referral to support. This study aimed to examine depression pre- and 5 years post-surgery to examine its prevalence and identify determinants.
Methods: the ColoREctal Wellbeing (CREW) study is a prospective UK cohort involving 872 adults with non-metastatic CRC recruited before curative-intent surgery. Questionnaires completed pre-surgery, and 3, 9, 15, 24, 36, 48 and 60 months post-surgery, captured socio-demographics, assessed depression (Centre for Epidemiologic Studies Depression Scale, CES-D) and other psychosocial factors. Clinical details were also gathered. We present prevalence of clinically significant depression (CES-D≥20) over time and its predictors assessed pre-surgery and 2 years post-surgery.
Results: pre-surgery, 21.0% of the cohort reported CES-D≥20 reducing to 14.7% 5 years post-surgery. Pre-surgery risk factors predicting subsequent depression: clinically significant depression and anxiety, previous mental health service use, low self-efficacy, poor health, having neoadjuvant treatment and low social support. Post-surgery risk factors at 2 years predicting subsequent depression: clinically significant depression, negative affect, cognitive dysfunction, accommodation type and poor health.
Conclusions: depression is highly pervasive in people with CRC, exceeding general population prevalence across follow-up. Our findings emphasise the need to screen and treat depression across the pathway. Our novel data highlights key risk factors of later depression at important and opportune timepoints: pre-surgery and the end of routine surveillance. Early recognition and timely referral to appropriate support is vital to improve long-term psychological outcomes.
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Prevalence and determinants of depression ...
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Accepted/In Press date: 17 June 2021
Published date: 25 November 2021
Additional Information:
ACKNOWLEDGEMENTS
We thank all CREW study participants and recruiting NHS Trusts; Carol Hill, Kerry Coleman, Bjoern Schukowsky, Christine May (study support); Matthew Breckons, Cassandra Powers, Alex Recio-Saucedo, Bina Nausheen, Ikumi Okamoto, Kim-Chivers Seymour, Joanne Haviland (researchers); Jo Clough, Alison Farmer (research partners).
Members of the Study Advisory Committee: Jo Armes, Janis Baird, Andrew Bateman, Nick Beck, Graham Moon, Claire Hulme, Peter Hall, Karen Poole, Susan Restorick-Banks, Paul Roderick, Claire Taylor, Jocelyn Walters, Fran Williams, Lynn Batehup, Jessica Corner and Deborah Fenlon. We would also like to thank Michael Sharpe for his valuable feedback on our manuscript and Angus McNair for his valuable advice.
Professor Alison Richardson is a National Institute for Health Research (NIHR) Senior Investigator. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
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Local EPrints ID: 451498
URI: http://eprints.soton.ac.uk/id/eprint/451498
ISSN: 1462-8910
PURE UUID: 1d98b84d-b148-4dff-acc8-69aeee76424f
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Date deposited: 04 Oct 2021 16:30
Last modified: 17 Mar 2024 06:49
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Author:
Deborah R Fenlon
Author:
Natalia Vadimovna Permyakova
Author:
Mubarak I Patel
Author:
Amy Din
Author:
Jane Winter
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