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Abstract
OBJECTIVE: To investigated the relation between pre-treatment 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. DS were measured using the Hospital Anxiety and Depression Scale (HADS) pre-treatment, at 4 and 12 months follow-up. Also socio-demographic, clinical, lifestyle and mortality data were collected. The association between pre-treatment DS (HADS-depression>7) and course (never DS, recovered from DS, or persistent/recurrent/late DS at 12 months follow-up), and survival was investigated using Cox regression. Unadjusted and adjusted analyses were performed.
RESULTS: In total, 384 of the 2,144 persons (18%) reported pre-treatment DS. Regarding DS course, 63% never had DS, 16% recovered, and 20% had persistent/recurrent/late DS. People with pre-treatment 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: Pre-treatment DS and persistent/recurrent/late DS were associated with worse survival among people with HNC.
Original language | English |
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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 - Sep 2018 |
Keywords
- cancer
- depression
- depressive symptoms
- head and neck cancer
- mortality
- oncology
- survival
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