eprintid: 10128003 rev_number: 20 eprint_status: archive userid: 608 dir: disk0/10/12/80/03 datestamp: 2021-05-18 11:20:13 lastmod: 2022-07-01 06:10:41 status_changed: 2021-05-18 11:20:13 type: article metadata_visibility: show creators_name: Walker, J creators_name: Mulick, A creators_name: Magill, N creators_name: Symeonides, S creators_name: Gourley, C creators_name: Burke, K creators_name: Belot, A creators_name: Quartagno, M creators_name: van Niekerk, M creators_name: Toynbee, M creators_name: Frost, C creators_name: Sharpe, M title: Major depression and survival in people with cancer ispublished: pub divisions: UCL divisions: B02 divisions: D65 divisions: J38 note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. abstract: OBJECTIVE: The question of whether depression is associated with worse survival in people with cancer remains unanswered because of methodological criticism of the published research on the topic. We aimed to study the association in a large methodologically robust study. METHODS: We analysed data on 20,582 patients with breast, colorectal, gynaecological, lung and prostate cancers who had attended cancer outpatient clinics in Scotland, UK. Patients had completed two-stage screening for major depression as part of their cancer care. These data on depression status were linked to demographic, cancer and subsequent mortality data from national databases. We estimated the association of major depression with survival for each cancer using Cox regression. We adjusted for potential confounders and interactions between potentially time-varying confounders and the interval between cancer diagnosis and depression screening, and used multiple imputation for missing depression and confounder data. We pooled the cancer-specific results using fixed-effects meta-analysis. RESULTS: Major depression was associated with worse survival for all cancers, with similar adjusted hazard ratios: breast cancer (HR 1.42, 95% CI 1.15-1.75), colorectal cancer (HR 1.47, 95% CI 1.11-1.94), gynaecological cancer (HR 1.36, 95% CI 1.08-1.71), lung cancer (HR 1.39, 95% CI 1.24-1.56), prostate cancer (HR 1.76, 95% CI 1.08-2.85). The pooled hazard ratio was 1.41 (95% CI 1.29-1.54, p<0.001, I2=0%). These findings were not materially different when we only considered the deaths (90%) that were attributed to cancer. CONCLUSIONS: Major depression is associated with worse survival in patients with common cancers. The mechanisms of this association and the clinical implications require further study. date: 2021-06 date_type: published official_url: http://doi.org/10.1097/PSY.0000000000000942 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1865109 doi: 10.1097/PSY.0000000000000942 pii: 00006842-900000000-98426 lyricists_name: Quartagno, Matteo lyricists_id: MQUAR28 actors_name: Flynn, Bernadette actors_id: BFFLY94 actors_role: owner full_text_status: public publication: Psychosomatic Medicine volume: 83 number: 5 pagerange: 410-416 event_location: United States citation: Walker, J; Mulick, A; Magill, N; Symeonides, S; Gourley, C; Burke, K; Belot, A; ... Sharpe, M; + view all <#> Walker, J; Mulick, A; Magill, N; Symeonides, S; Gourley, C; Burke, K; Belot, A; Quartagno, M; van Niekerk, M; Toynbee, M; Frost, C; Sharpe, M; - view fewer <#> (2021) Major depression and survival in people with cancer. Psychosomatic Medicine , 83 (5) pp. 410-416. 10.1097/PSY.0000000000000942 <https://doi.org/10.1097/PSY.0000000000000942>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10128003/1/MAJOR_DEPRESSION_AND_SURVIVAL_IN_PEOPLE_WITH.98426.pdf