Abstract
BACKGROUND: Anxiety and depression are significant contributors to adverse outcomes in patients with colon cancer (CC). Therefore, investigating the key determinants of this psychological distress in such patients is essential. AIM: To examine the correlation of anxiety/depression status with stress-related markers and cancer-related fatigue (CRF), along with associated risk factors in patients with CC. METHODS: The study enrolled 120 patients with CC treated at the Affiliated Yongchuan Hospital of Chongqing Medical University between February 2022 and February 2025. Initially, patients' anxiety [Self-Rating Anxiety Scale (SAS)] and depression [Self-Rating Depression Scale (SDS)] status were assessed first and then stratified into the anxiety/depression group (n = 62, SAS ≥ 50 or SDS ≥ 53) and control group (n = 58). Comparative assessments were conducted for stress-related markers [heat shock protein 70 (HSP70) and C-reactive protein (CRP)] and CRF [Brief Fatigue Inventory-Chinese version (BFI-C)] at three measurement time points: Preoperative (T0), postoperative day 3 (T1), and postoperative day 7 (T2). Correlations between anxiety/depression status and HSP70, CRP, and BFI-C in patients with CC were analyzed using Pearson's method, whereas univariate and multivariate regression identified independent predictors of anxiety or depressive symptoms in such patients. RESULTS: The analysis revealed prevalence rates of 30.00% for anxiety and 38.33% for depression among the 120 patients with CC, of whom 51.67% exhibited either condition, and 16.67% showed comorbidity. Both groups showed an initial increase in HSP70, CRP, and BFI-C followed by a decrease compared with those at T0, with the anxiety/depression group exhibiting markedly higher levels of HSP70, CRP, and BFI-C at T1 and T2. Subsequent correlation analysis revealed strong positive correlations between SAS and SDS scores and HSP70, CRP, and BFI-C concentrations. Univariate analysis identified sex, age, marital status, monthly household income, tumor stage, and comorbidities as factors closely associated with anxiety or depression. Multivariate analysis further established female sex [odds ratio (OR) = 2.755], age ≥ 60 years (OR = 2.649), and advanced tumor stage (III-IV, OR = 2.349) as independent predictors of anxiety or depression in patients with CC. CONCLUSION: A subset of patients with CC exhibits anxiety and depressive symptoms, which are significantly positively correlated with stress-related markers and CRF. Moreover, patients with CC, female patients, those aged 60 years or older, and patients diagnosed with stage III-IV tumors are more prone to anxiety or depression.