Ann Surg Treat Res.  2023 Jun;104(6):303-312. 10.4174/astr.2023.104.6.303.

Long-term incidence of depression in rectal cancer patients with or without stoma: a population-based cohort study

• Kim HJ
• Ahn HS
• Ji WB

• KMID: 2542794
• DOI: http://doi.org/10.4174/astr.2023.104.6.303

Abstract

Purpose
Significant improvements have been made in the surgical treatment of rectal cancer with a higher sphinctersaving rate without compromising oncologic results. There have been studies about the quality of life of rectal cancer patients after surgery. However, no study has reported the long-term annual incidence of depression after rectal cancer surgery according to stoma status. The objective of this study was to determine the annual incidence of depression after rectal cancer surgery and the factors affecting it, especially the prevalence of depression according to the presence or duration of a stoma.
Methods
Using the Korea National Health Insurance Service database, patients who underwent radical surgery for rectal cancer from 2002 to 2019 were searched. We analyzed the incidence and risk factors of depression in patients who underwent radical surgery for rectal cancer according to stoma status.
Results
Annual incidence of depression in rectal cancer patients was decreasing annually for 15 years after surgery. There was no statistically significant difference in the incidence of depression according to the stoma status. However, the diagnosis of depression within 1 year after surgery was statistically significantly increased in the permanent stoma group.
Conclusion
There was no difference in the overall incidence of depressive disorders among patients with rectal cancer based on their stoma status. However, a permanent stoma seems to increase the incidence in the first year after surgery. Education and intensive assessments of depressive disorders in patients with permanent stoma within 1 year after surgery are needed, particularly for female patients who are under 50 years old.

Keyword

Depression; Rectal neoplasms; Surgical stomas

Figure

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  Fig. 1 The annual incidence of depressive disorder in rectal cancer and incidence rate ratio (IRR). Ref, reference; CI, confidence interval.

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  Fig. 2 Cumulative incidence of the depressive disorder according to stoma status.

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  Fig. 3 Cumulative incidence of depressive disorder according to age and sex. (A) Male patients aged <50 years. (B) Male patients aged ≥50 years. (C) Female patients aged <50 years. (D) Female patients aged ≥50 years.

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