Cancer survivors and their partners at greater risk of anxiety than depression in long term

Contrary to popular belief, long-term cancer survivors are not at substantially increased risk of depression compared with their healthy counterparts, but are about a quarter more likely to experience anxiety, new research published Online First in The Lancet Oncology indicates. Moreover, partners face similar levels of depression but even higher rates of anxiety as cancers survivors themselves.

"Depression is an important problem after cancer but it tends to improve within 2 years of a diagnosis unless there is a further complication. Anxiety is less predictable and is a cause for concern even 10 years after a diagnosis. However, detection of anxiety has been overlooked compared with screening for distress or depression"*, explains lead author Alex Mitchell from Leicester General Hospital in the UK.

The number of people being diagnosed with cancer each year is set to exceed 21 million by 2020. Cancer survivors are living longer—about 70% of patients now live for at least 5 years after diagnosis— but little is known about cancer's lasting effect on the mental health of survivors and their families.

This new study shows that while levels of depression in adult cancer survivors 2 years or more after diagnosis are roughly equal to adults with no history of cancer (11.6% vs 10.2%), survivors are significantly (27%) more likely to experience anxiety, rising to 50% more likely in the 10 years or more after diagnosis.

What is more, while survivors and their partners appear to suffer similar levels of depression (RR 1.01), partners seem to experience even more anxiety than survivors themselves (28.0% vs 40.1%; RR 0.71).

The systematic review and meta-analysis looked at 43 comparisons in 27 publications involving about half a million participants reporting the prevalence of depression or anxiety in adults with cancer at least 2 years after diagnosis.

According to Mitchell, "Our results suggest that, after a cancer diagnosis, increased rates of anxiety tend to persist in both patients and their relatives. When patients are discharged from hospital care they usually receive only periodic check-ups from their medical teams and this autonomy in the post-acute period can be anxiety provoking. Further, the provision of rehabilitation and specialist emotional help is currently patchy. Efforts should be made to improve screening for anxiety and increase follow-up support for both survivors and their families."