Changes in depression symptoms over time are associated with differences in survival among patients with lung cancer, especially those with early stage disease, according to a study published in the Journal of Clinical Oncology.1

Although depression symptoms are common among patients with lung cancer, it remains unclear as to how longitudinal changes in these symptoms impact survival. Therefore, researchers sought to prospectively evaluate associations between depression and mortality in patients with lung cancer.

For the observational study, investigators enrolled 1790 patients living in the United States within 3 months of their lung cancer diagnosis. Participants completed the 8-item Center for Epidemiologic Studies Depression scale, which was administered at diagnosis and 12 months of follow-up.

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Results showed that 38% had depression symptoms at baseline and an additional 14% developed new-onset depression symptoms during cancer treatment.

Investigators found that depression symptoms at baseline were significantly associated with a 17% higher risk of mortality (hazard ratio [HR], 1.17; 95% CI, 1.03-1.32; P =.01).

The study further demonstrated that patients with new-onset depression symptoms (HR, 1.50; 95% CI, 1.12-2.01; P =.006) and those with persistent depression symptoms (HR, 1.42; 95% CI, 1.15-1.75; P =.001) had a 42% to 50% higher risk of death compared with those who never had depression symptoms; however, there was no significant difference in mortality between patients in depression symptom remission and those who never had symptoms (HR, 1.02; 95% CI, 0.79-1.31; P =.89).

In addition, subgroup analyses showed that depression symptoms at baseline were associated with increased mortality among patients with stage I and II lung cancer (HR, 1.61; 95% CI, 1.26-2.04), but not among those with stage III or IV disease (HR, 1.05; 95% CI, 0.91-1.22). At 12 months of follow-up, depression symptoms were associated with a higher risk of death among both groups, with a greater effect observed in patients with early stage disease (HR, 1.71; 95% CI, 1.27-2.31).


1. Sullivan DR, Forsberg CW, Ganzini L, et al. Longitudinal changes in depression symptoms and survival among patients with lung cancer: a national cohort assessment. J Clin Oncol. 2016 Oct 3. doi: 10.1200/JCO.2016.66.8459. [Epub ahead of print]