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

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 ( = 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 ( < .05), although only age at diagnosis contributed statistical significance to the model. Depressive symptoms predicted shorter survival from date of diagnosis ( < .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 ( < .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.