Psychological symptoms and subsequent healthy lifestyle after a colorectal cancer diagnosis.

Trudel‐Fitzgerald, Claudia; Tworoger, Shelley S.; Poole, Elizabeth M.; Zhang, Xuehong; Giovannucci, Edward; Meyerhardt, Jeffrey A.; Kubzansky, Laura D.

doi:10.1037/hea0000571

Cited by 27 publications

(26 citation statements)

References 69 publications

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Section: Discussionmentioning

confidence: 99%

“…Previous research on psychological health and lifestyle behavior among CRC survivors has shown an association between higher psychological distress and an unhealthier lifestyle [6,31,32]. Trudel-Fitzgerald et al [31] found that among women with CRC from the Nurses' Health Study prospective cohort in the USA, higher levels of anxiety and depression symptoms were associated with subsequent unhealthier lifestyle in the 10 years following CRC diagnosis [31]. Although, to our knowledge, no other study has specifically assessed the association between psychological distress and diet quality among CRC survivors, two studies have assessed the association between psychological distress and physical (in)activity in CRC survivors [6,32].…”

Section: Discussionmentioning

confidence: 99%

“…Dietary support for CRC survivors with overweight or obesity should incorporate support in dealing with CRCrelated barriers to achieve and maintain dietary changes [25], including disease and treatment-related complaints [2,13], such as psychological distress. Psychological distress is common in CRC survivors [19,22] and in individuals with overweight or obesity [17], and has been associated with an unhealthier lifestyle [6,31,32] and a poorer health-related quality of life (HRQoL) in CRC survivors [15,19]. In addition, HRQoL has been negatively associated with meeting lifestyle and body weight recommendations in CRC survivors [3,12,35].…”

Section: Introductionmentioning

confidence: 99%

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Psychological distress and lower health-related quality of life are associated with need for dietary support among colorectal cancer survivors with overweight or obesity

Ramp

Mols

Ezendam

et al. 2021

Support Care Cancer

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Objective Two-third of colorectal cancer (CRC) survivors are overweight or obese. Psychological distress and low health-related quality of life (HRQoL) may be barriers to improving diet. We aimed to assess associations between psychological distress and HRQoL and the need for dietary support in CRC survivors with overweight or obesity. Methods All alive individuals diagnosed with CRC between 2000 and 2009, as registered by the Dutch population-based Eindhoven Cancer Registry, were eligible for participation and received a questionnaire. Multivariable logistic regression analyses were conducted to assess associations between HRQoL (EORTC QLQ-C30), symptoms of anxiety and depression (HADS), and self-reported need for dietary support (single-item). Results A total of 1458 completed the questionnaire (response rate 82%), and 756 (43%) had a BMI of 25.0 or higher and complete data on “need for dietary support” and were included for analyses. BMI ranged between 25.0 and 60.6 (mean, 28.9; SD, 3.6). The majority (71.7%) was overweight (BMI ≥ 25), and 28.3% obese (BMI ≥ 30). Twenty-one percent reported a need for dietary support which was associated with more psychological distress and lower HRQoL. Those who experienced symptoms of anxiety or depression were more likely to report a need for dietary support (27.6% and 28.7%) than those who did not experience symptoms of anxiety (12.3%; OR 2.02; 95% CI 1.22–3.35) or depression (13.5%; OR 1.96; 95% CI 1.19–3.22). Conclusions Results suggest that psychological distress and lower HRQoL should be taken into account while promoting a healthy diet in overweight or obese CRC survivors since these factors may hinder adherence to a healthy diet.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Psychological distress and lower health-related quality of life are associated with need for dietary support among colorectal cancer survivors with overweight or obesity

Ramp

Mols

Ezendam

et al. 2021

Support Care Cancer

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“…Various mechanisms may explain the observed distress-mortality association. A less healthy lifestyle, as defined by engaging in fewer healthy behaviors and having an unhealthy BMI, is related to having more distress symptoms [ 45 ] and with reduced subsequent overall and cancer-specific survival [ 46 ] among CRC patients. In our study, accounting for lifestyle at baseline and 4 years later did not alter the relationship of anxiety or depression with mortality, suggesting behavioral factors are not a primary pathway.…”

Section: Discussionmentioning

confidence: 99%

Anxiety, Depression, and Colorectal Cancer Survival: Results from Two Prospective Cohorts

Trudel‐Fitzgerald

Tworoger

Zhang

et al. 2020

JCM

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Given the unalterable nature of most risk factors for colorectal cancer (CRC) survival (e.g., disease stage), identifying modifiable determinants is critical. We investigated whether anxiety and depression were related to CRC survival using data from the Nurses’ Health Study (NHS) and Health Professional Follow-up Study (HPFS). Participants who received a CRC diagnosis and provided information about anxiety (nNHS = 335; nHPFS = 232) and depression (nNHS = 893; nHPFS = 272) within 4 years of diagnosis were included. Cox regression models estimated hazard ratios (HR) and 95% confidence intervals (CI) of overall mortality, while controlling for covariates (sociodemographics, cancer characteristics, and lifestyle factors). Pooled risk estimates were derived from fixed effects meta-analyses of the cohorts. Among 1732 CRC patients, 814 deaths occurred during the 28-year follow-up. Each 1 standard deviation increase in anxiety or depression symptoms was associated with a similar 16% higher mortality risk (anxiety: 95% CI = 1.05–1.29; depression: 95% CI = 1.07–1.26). Comparable results were observed across all sensitivity analyses (introducing a 1-year lag, restricting to CRC-related mortality, considering potential behavioral pathways) and stratified models (cancer stage, sex). Our findings suggest greater anxiety and depression symptoms can not only impede adherence to healthy habits and reduce quality of life in cancer patients but could also be a marker for accelerated CRC progression.

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“…In this pooled sample of two Dutch CRC survivor cohorts, we observed that alcohol consumption is slightly decreasing after Over time, we found that survivors who were male, with higher education, more physical activity, and survivors without a stoma reported higher consumption of alcoholic drinks. At baseline, we found that our study population had more alcohol consumers than reported in other cancer survivor studies: 49% current consumers [14], 8% moderate consumers [24], and 88% low alcohol consumption (≤ 1 drink/day) [25], but all alcoholic consumptions seemed to decrease slightly in the 2 years post-diagnosis. This was in line with the paper of Bours et al stating that 95% drank less alcohol after CRC diagnosis in a cross-sectional study 7 years post-diagnosis [26].…”

Section: Discussionmentioning

confidence: 44%

Longitudinal associations of sociodemographic, lifestyle, and clinical factors with alcohol consumption in colorectal cancer survivors up to 2 years post-diagnosis

Révész

Bours

Wegdam

et al. 2021

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Purpose Alcohol consumption can lead to worse prognosis and mortality among colorectal cancer (CRC) patients. We investigated alcohol consumption of CRC survivors up to 2 years post-diagnosis, and how sociodemographic, lifestyle, and clinical factors were associated longitudinally with these habits. Methods We pooled longitudinal data of 910 CRC survivors from the ongoing PROCORE and EnCoRe studies with data collected at diagnosis (baseline) and 3, 6, 12, and 24 months post-diagnosis. Both studies assessed alcohol consumption, including beer, wine, and liquor. Generalized estimated equation models were used to examine changes over time in alcohol consumption and multivariable longitudinal associations of sociodemographic, lifestyle, and clinical factors with alcohol consumption. Results At baseline, participants were on average 67 years old, 332 (37%) were female, and alcohol was consumed by 79%. Most survivors (68–71%) drank less at all follow-ups. Beer, wine, and liquor were consumed by 51%, 58%, and 25% at baseline, respectively, and these declined over time. Males consumed more alcohol, and higher education, more physical activity, and not having a (permanent) stoma were associated with consuming more alcohol. Conclusion CRC survivors decreased their alcohol consumption in the 2 years post-diagnosis. Future studies should take the significant factors that were associated with alcohol post-diagnosis consumption into account, when they investigate CRC health outcomes or for identifying subgroups for interventions. Males with higher education, more physical activity, and no stoma should be reminded after diagnosis for reducing their alcohol consumption.

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Psychological symptoms and subsequent healthy lifestyle after a colorectal cancer diagnosis.

Cited by 27 publications

References 69 publications

Psychological distress and lower health-related quality of life are associated with need for dietary support among colorectal cancer survivors with overweight or obesity

Psychological distress and lower health-related quality of life are associated with need for dietary support among colorectal cancer survivors with overweight or obesity

Anxiety, Depression, and Colorectal Cancer Survival: Results from Two Prospective Cohorts

Longitudinal associations of sociodemographic, lifestyle, and clinical factors with alcohol consumption in colorectal cancer survivors up to 2 years post-diagnosis

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