Psychological Distress Screening in Patients with Esophageal Cancer after Esophagectomy: Evaluation of the Published Evidence

Authors: Erietta-Christina Arnaoutaki, Stelios-Elion Bousi, Marinos Zachiotis, Simoni Zarkada, Alexandra Chrysagi, Mamdouh Fahad Alenazi, Dimitri Aristotle Raptis

Abstract:

This paper aimed to evaluate the mental health status of patients with esophageal cancer following surgical treatment, as well as the role of psychological distress screening tests in this patient population. Studies reporting psychometric screening tools used in esophageal cancer patients after esophagectomy, published before January 2024 on PubMed, Scopus, and CENTRAL databases, were searched and analyzed. Six non-randomized control trials were selected for inclusion in this study which involved 1059 patients undergoing esophagectomy for esophageal cancer. Among the included studies, five employed the Hospital Anxiety and Depression Scale (HADS) for anxiety and/or depression screening, while one used the MD Anderson Symptom Inventory for gastrointestinal cancer (MDASI-GI) for sadness screening. A range of time points was used to evaluate these patients: 102 patients were evaluated at 1 month, 230 patients at 3 months, 218 patients at 6 months, 653 patients at 12 months, and 154 patients at 24 months postoperatively. Analysis of data pooled from three studies employing the HADS revealed a prevalence of 19.45% for anxiety and 17.92% for depression at the 12-month follow-up and mean scores of 3.91 (3.12) and 3.56 (3.12) for the HADS anxiety (HADS-A) and depression (HADS-D) subscales respectively, at any time postoperatively. The findings show a neglected concern regarding the mental health of esophageal cancer survivors following surgical treatment. The use of psychometric screening tools is essential to address psychological distress and improve the quality of life of these patients.

Keywords: Esophageal cancer, esophagectomy, psychological distress, anxiety, depression, psychometric tests, HADS, MDASI-GI.

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