Prevalence, risk factors and prognostic value of anxiety and depression in cervical cancer patients underwent surgery

BACKGROUND: This study aimed to explore the prevalence and risk factors of anxiety and depression, as well as the association of anxiety and depression with survival profiles in cervical cancer patients underwent surgery. METHODS: A total of 158 newly diagnosed primary cervical cancer patients who underwent surgical resection were recruited, and another 150 healthy subjects were also included as controls. Anxiety and depression were assessed using the hospital anxiety and depression scale (HADS). Disease-free survival (DFS) and overall survival (OS) were calculated. RESULTS: The HADS-anxiety (HADS-A) score, the prevalence and the severity of anxiety were greatly increased in cervical cancer patients compared with controls. Meanwhile, the HADS-depression (HADS-D) score, the prevalence and the severity of depression were also dramatically elevated in cervical cancer patients compared with controls. As for risk factors, diabetes and International Federation of Gynecology and Obstetrics (FIGO) stage II were independent factors for higher anxiety risk, and diabetes as well as lymph node metastasis were independent predictive factors for increased depression risk in cervical cancer patients. Besides, cervical cancer patients with anxiety had less prolonged DFS and OS compared with those without anxiety, and cervical cancer patients with depression had shorter OS compared with those without depression. CONCLUSIONS: Anxiety and depression are highly prevalent, and associates with worse tumor burden as well as unfavorable survival profiles in cervical cancer patients underwent surgery.