High Frequencies of Depressive Symptoms After Treatment for Colorectal Cancer: a Systematic Review and Meta-analysis

The aim of this study was to clarify the frequency of depressive symptoms and depression within a year after treatment for colorectal and anal cancer. Systematic searches were conducted in Cochrane CENTRAL, PubMed, and Embase including studies published from year 2000 to 17 January 2022. Eligible studies included adult patients with colorectal or anal cancer and with minimum 50 participants. Bias was assessed using the National Institutes of Health quality assessment tool for cross-sectional studies, the Newcastle–Ottawa scale for cohort studies, and the Cochrane risk of bias tool-1 for randomized controlled trials. The outcome was the number of patients with depressive symptoms and depression from each study presented as pooled frequencies using one-group meta-analysis. The meta-analyses were performed using a binary random effects DerSimonian-Laird model. In total, 35 studies and 9182 patients with colorectal cancer were included. The pooled frequencies of depressive symptoms were 24% before treatment, 29% 0– ≤ 3 months after the treatment started, 27% after > 3– ≤ 6 months, and 21% after > 6– ≤ 12 months. Depressive symptoms were assessed in all 35 studies. Depression was assessed in 12 studies and included 5778 patients. The pooled frequencies of depression were 24% before treatment, 27% 0– ≤ 3 months after the treatment started, 39% after > 3– ≤ 6 months, and 25% after > 6– ≤ 12 months. There were almost no data available on patients with anal cancer. Depressive symptoms and depression are common within the first year after treatment initiation of colorectal cancer. The reported frequency of depressive symptoms and depression was high and varied widely between studies.