Lena Wettergren

Anxiety and Depression Trajectories in Young Adults Up to 5 Years After Being Diagnosed With Cancer

ABSTRACTAimsThis study aimed to identify and characterize trajectories of anxiety and depression symptoms in a national cohort of young women and men up to 5 years after being diagnosed with cancer. Furthermore, potential sociodemographic, clinical, and psychosocial factors predictive of different trajectory groups were examined.MethodsA population‐based sample of 1010 young adults aged 18–39 at diagnosis with selected cancers/tumors (brain/breast/cervical/lymphoma/ovarian/testicular) completed a survey 1.5 years, 3 years (T2, n = 722) and 5 years (T3, n = 659) post‐diagnosis. Responses to the Hospital Anxiety and Depression Scale were computed using five trajectories as outcome groups: Stable cases, Stable non‐cases, Improving, Worsening, and Fluctuating. Multinomial logistic regression models were performed to identify predictive factors of different trajectories.ResultsThe most common trajectories for anxiety symptoms were Stable non‐cases (36%) and Stable cases (26%), followed by Improving (17%), Fluctuating (11%), and Worsening (10%). In contrast, the dominant trajectory for depression symptoms was Stable non‐cases (69%), with smaller groups identified as Improving (10%), Worsening (8%), Stable cases (7%), and Fluctuating (6%). Factors associated with several unfavorable trajectories were female sex, pre‐diagnosis support for emotional issues, fatigue, and financial problems (p < 0.05).ConclusionSymptoms of anxiety and depression follow five different developmental paths among young people with cancer. Within the first 5 years after a cancer diagnosis, a majority of young adults meet clinical levels of anxiety (64%) and a third meet clinical levels of depression (31%). It is important to consider risk factors for mental illness in the follow‐up care of people with cancer.

Health-related quality of life among adult patients with cancer in Uganda – a cross-sectional study

The study aimed to investigate the prevalence and factors associated with poor health-related quality of life in adults with cancer in Uganda. This cross-sectional study surveyed 385 adult patients (95% response rate) with various cancers at a specialised oncology facility in Uganda. Health-related quality of life was measured using the EORTC QLQ-C30 in the Luganda and English languages. Predetermined validated clinical thresholds were applied to the instrument in order to identify patients with poor health-related quality of life, that is, functional impairments or symptoms warranting concern. Multivariable logistic regression was used to identify factors associated with poor health-related quality of life in six subscales: Physical Function, Role Function, Emotional Function, Social Function, Pain and Fatigue. The mean age of the patients was 48 years. The majority self-reported poor functioning ranging between 61% (Emotional Function) to 79% (Physical Function) and symptoms (Fatigue 63%, Pain 80%) at clinically concerning levels. These patients were more likely to be older, without formal education and not currently working. Being an inpatient at the facility and being diagnosed with cervical cancer or leukaemia was a predictor of poor health-related quality of life. Improvement of cancer care in East Africa requires a comprehensive and integrated approach that addresses various challenges specific to the region. Such strategies include investment in healthcare infrastructure, for example, clinical guidelines to improve pain management, and patient education and support services.