Depression and health utility were associated with survival in patients with advanced colorectal cancer (CRC), while optimism, hope, or anxiety were not, a new study published in the journal Supportive Care in Cancer has shown.1

Because psychological responses to cancer are believed to impact survival, researchers sought to evaluate associations between hope, optimism, anxiety, depression, and health utility, and survival in patients initiating first-line chemotherapy for metastatic CRC.

Researchers analyzed responses from questionnaires completed at baseline in 429 patients with metastatic CRC who participated in a randomized, controlled trial of chemotherapy. The questionnaire assessed hopefulness, optimism, anxiety and depression, and health utility.

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Results showed that at a median follow-up of 31 months, overall survival was negatively associated with depression (HR, 1.72; P<.001) and positively associated with health utility (HR, 0.73; P=.014). Researchers found that optimism, anxiety, or depression were not associated with overall survival.

The study also demonstrated that hope, optimism, anxiety, or depression were not associated with progression-free survival in any analysis.

“Further research is required to understand the nature of the relationship between depression and survival,” the investigators conclude. “If a causal mechanism is identified, this may lead to interventional possibilities.”


1. Schofield PE, Stockler, MR, Zannino D, et al. Hope, optimism and survival in a randomised trial of chemotherapy for metastatic colorectal cancer. Supp Care Cancer. 2016;24(1):401-408.