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Meta-Analysis
. 2022 Nov 15;29(11):8751-8766.
doi: 10.3390/curroncol29110689.

Colorectal Cancer and Onset of Anxiety and Depression: A Systematic Review and Meta-Analysis

Vicki Cheng  1   2 , Niki Oveisi  1   2 , Helen McTaggart-Cowan  3   4 , Jonathan M Loree  5   6 , Rachel A Murphy  3   7 , Mary A De Vera  1   2   8
Affiliations
Meta-Analysis

Colorectal Cancer and Onset of Anxiety and Depression: A Systematic Review and Meta-Analysis

Vicki Cheng et al. Curr Oncol. .

Abstract

Research suggests that colorectal cancer (CRC) is associated with mental health disorders, primarily anxiety and depression. To synthesize this evidence, we conducted a systematic review and meta-analysis of studies evaluating the onset of anxiety and depression among patients with CRC. We searched EMBASE and Medline from inception to June 2022. We included original, peer-reviewed studies that: used an epidemiologic design; included patients with CRC and a comparator group of individuals without cancer; and evaluated anxiety and depression as outcomes. We used random effects models to obtain pooled measures of associations. Quality assessment was completed using the Newcastle-Ottawa scale. Of 7326 articles identified, 8 were eligible; of which 6 assessed anxiety and depression and 2 assessed depression only. Meta-analyses showed a non-significant association between CRC and anxiety (pooled HR 1.67; 95% CI 0.88 to 3.17) and a significant association between CRC and depression (pooled HR 1.78; 95% CI 1.23 to 2.57). Predictors of anxiety and depression among patients with CRC included clinical characteristics (e.g., comorbidities, cancer stage, cancer site), cancer treatment (e.g., radiotherapy, chemotherapy, colostomy), and sociodemographic characteristics (e.g., age, sex). The impacts of anxiety and depression in patients with CRC included increased mortality and decreased quality of life. Altogether, our systematic review and meta-analysis quantified the risks and impacts of CRC on anxiety and depression, particularly an increased risk of depression after CRC diagnosis. Findings provide support for oncologic care that encompasses mental health supports for patients with CRC.

Keywords: anxiety; colorectal cancer; depression; mental health.

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Conflict of interest statement

J.M.L has received research funding from Ipsen, Amgen and Foundation Medicine and consulting fees from Roche, Bayer, Amgen, Ipsen, Advanced Accelerator Applications and Novartis. All other authors declare that they have no conflicts of interests.

Figures

Figure 1
Figure 1
PRISMA.
Figure 2
Figure 2
Pooled hazard ratios for anxiety and depression in patients with CRC. (A) Anxiety (n = 5); (B) Anxiety (n = 5); (C) Depression (n = 6); (D) Depression (n = 5).
Figure 2
Figure 2
Pooled hazard ratios for anxiety and depression in patients with CRC. (A) Anxiety (n = 5); (B) Anxiety (n = 5); (C) Depression (n = 6); (D) Depression (n = 5).
See this image and copyright information in PMC

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