Depressive symptoms and shorter survival in lung cancer: the role of leukocyte telomere length

Abstract

Objective

To examine the association between depressive symptoms, leukocyte telomere length–a marker of cellular ageing, and survival amongst lung cancer patients.

Design

Patients with non-small cell lung cancer were recruited from a university-affiliated cancer center clinic.

Main Outcome

Patients (N = 67) reported on depressive symptoms and provided a blood sample for leukocyte telomere length assessment at baseline and at a 3-month follow-up. Survival status was tracked over 3 years.

Results

Age at diagnosis and depressive symptoms, as measured by the CES-D, were associated with shorter leukocyte telomere length (p < .05), although only age at diagnosis contributed statistical significance to the model. Depressive symptoms predicted shorter survival from date of diagnosis (p < .01). Patients who reported experiencing clinically meaningful levels of depressive symptoms (CES-D scores ≥ 16) demonstrated shorter survival than those who reported sub-clinical levels of depressive symptoms (p < .05). Leukocyte telomere length did not emerge as a predictor of shorter survival.

Conclusion

Clinically meaningful levels of depressive symptoms are associated with shorter survival amongst lung cancer patients. These findings support the on-going efforts to screen all cancer patients for low mood and to investigate mechanisms linking depressive symptoms and shorter survival in cancer contexts.

Keywords:

• Lung cancer
• survival
• depression
• leukocyte telomere length

Acknowledgements

The authors wish to thank all institutions and patients who participated in this research.

Disclosure statement

No conflict of interest was reported by the authors.

Funding

This study was supported by the Kentucky Lung Cancer Research Program (PI, Sephton, S.E.). Dr. Chelsea Siwik was supported by a National Center for Complimentary and Integrative Health T32 Fellowship (5T32AT003997-13) at the University of California, San Francisco.

Data availability statement

The data that support the findings of this study are available from the corresponding author, S.E.S., upon reasonable request.