ArticleBMJ oncology2026
Incidence of new-onset depression after colorectal cancer diagnosis and associated mortality: a population-based cohort study.
Article in BMJ oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: To examine the incidence of and factors associated with new-onset depression following colorectal cancer (CRC) diagnosis and its association with all-cause and CRC-specific mortality. Design: Population-based retrospective cohort study using linked administrative health databases. Setting: British Columbia, Canada. Participants: Individuals diagnosed with CRC from 2010 to 2017 without a history of physician-recorded depression diagnoses in the 5 years preceding the CRC diagnosis. Main outcome measures: New-onset depression following CRC diagnosis was identified using International Classification of Diseases (ICD)-9 and ICD-10 diagnostic codes. Cumulative incidence and incidence rates of new-onset depression were estimated, and factors associated with new-onset depression were examined using Cox proportional hazards models. Depression was modelled as a time-varying exposure in mortality analyses, with Cox proportional hazards models used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for all-cause and CRC-specific mortality. Results: Among 13 986 patients with CRC (55.2% males, mean age 66.0), the 5-year cumulative incidence of new-onset depression among those without a history of depression was 6.63% following CRC diagnosis. Incidence rates were highest in the first year post-CRC diagnosis (3.54 per 100 person-years), indicating that new-onset depression was most common early after diagnosis. Factors associated with new-onset depression included female sex (HR 1.40 (95% CI 1.22 to 1.61)) and stage 4 disease (HR 1.77 (95% CI 1.34 to 2.33)). New-onset depression after CRC diagnosis was associated with 97% higher all-cause mortality (HR 1.97 (95% CI 1.74 to 2.23)) and 73% higher CRC-specific mortality (HR 1.73 (95% CI 1.48 to 2.03)). Conclusions: The cumulative incidence of new-onset depression increased over time, with incidence rates highest in the first year following CRC diagnosis. New-onset depression after CRC diagnosis was associated with higher all-cause and CRC-specific mortality. Findings highlight the importance of early identification of patients at high risk for depression and consideration of longitudinal mental healthcare in CRC care.
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