High level of unmet needs and anxiety are associated with delayed initiation of adjuvant chemotherapy for colorectal cancer patients

Support Care Cancer. 2020 Nov;28(11):5299-5306. doi: 10.1007/s00520-020-05333-z. Epub 2020 Feb 28.

Abstract

Aims: Adjuvant chemotherapy is recommended for patients with curatively resected colorectal cancer. The aim of this study is to evaluate the impact of unmet supportive care needs and anxiety on the initiation of postoperative adjuvant chemotherapy in colorectal cancer patients.

Methods: This is a retrospective study from a single tertiary referral hospital. Patients diagnosed with colorectal cancer who met the inclusion criteria were included. The Hospital Anxiety and Depression Scale (HADS) and modified 34-item Supportive Care Needs Survey (SCNS-SF34) were applied to assess patient's anxiety level and unmet needs. The time intervals between initiation of adjuvant chemotherapy and operation were recorded. Factors associated with delayed initiation of chemotherapy were investigated in univariate and multivariate analysis.

Results: A total of 135 patients with colorectal cancer were included. In total, 16.3% (22/135) and 5.2% (7/135) reported symptoms of anxiety and depression. In multivariate analysis, low to moderate income status, postoperative complications, anxiety, and high level of unmet needs are independent risk factors for late initiation of chemotherapy.

Conclusions: Our findings showed that psychological problems such as anxiety and high unmet supportive needs are correlated with delayed initiation of adjuvant chemotherapy in colorectal cancer patients.

Keywords: Adjuvant chemotherapy; Anxiety; Colorectal cancer; Delay initiation of chemotherapy; Depression; Patient’s needs; SCNS-SF34.

MeSH terms

  • Adult
  • Aged
  • Anxiety / complications
  • Anxiety / epidemiology*
  • Chemotherapy, Adjuvant
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / epidemiology*
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / psychology
  • Depression / complications
  • Depression / epidemiology
  • Female
  • Health Services Needs and Demand / standards
  • Health Services Needs and Demand / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Needs Assessment
  • Prevalence
  • Retrospective Studies
  • Surveys and Questionnaires
  • Time-to-Treatment / statistics & numerical data*