title: Self-reported depression and perceived financial burden among long-term rectal cancer survivors.
abstract: Types of surgery for rectal cancer (RC), including permanent ostomy (PO) or temporary ostomy followed by anastomosis (TO) or initial anastomosis (AN), can affect psychological and financial well-being during active treatment. However, these relationships have not been well studied among long-term survivors (≥5 years post-diagnosis).
  
  
  
  A mailed survey with 576 long-term RC survivors who were members of Kaiser Permanente was conducted in 2010-2011. Prevalence of current depression was ascertained using a score of ≤45.6 on the Short Form-12 version 2 mental component summary. Perceived financial burden was assessed using a Likert scale ranging from 0 (none) to 10 (severe). Regression analyses were used to measure associations after adjustment for covariates.
  
  
  
  The overall prevalence of depression was 24% among RC survivors with the highest prevalence among those with a history of PO (31%). The adjusted odds of depression among TO and AN survivors were lower than that among PO survivors, 0.42 (CI95%0.20-0.89) and 0.59 (CI95%0.37-0.93), respectively. Twenty-two percent perceived moderate-to-high current financial burden (≥4 points). PO survivors also reported higher mean financial burden than AN survivors (2.6 vs. 1.6, respectively; p = 0.002), but perceived burden comparably to TO survivors (2.3). Self-reported depression was associated with higher perceived financial burden (p < 0.001); surgical procedure history did not modify this relationship.
  
  
  
  Depression was reported frequently among these long-term RC survivors, particularly among PO survivors. Depression was associated with greater perception of financial burden. Screening for depression and assessing financial well-being might improve care among long-term RC survivors.Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: The University of Arizona College of Public Health, 1295 N. Martin Ave., Tucson, AZ, 85724, USA. chongpis@email.arizona.edu.
authors.forename: Yuda
authors.initials: Y
authors.lastname: Chongpison
authors.affiliation: Kaiser Permanente Northwest, 3800 N. Interstate Ave., Portland, OR, 97227, USA.
authors.forename: Mark C
authors.initials: MC
authors.lastname: Hornbrook
authors.affiliation: The University of Arizona College of Public Health, 1295 N. Martin Ave., Tucson, AZ, 85724, USA.
authors.forename: Robin B
authors.initials: RB
authors.lastname: Harris
authors.affiliation: Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Herrinton
authors.affiliation: The University of Arizona College of Public Health, 1295 N. Martin Ave., Tucson, AZ, 85724, USA.
authors.forename: Joe K
authors.initials: JK
authors.lastname: Gerald
authors.affiliation: City of Hope Medical Center/Beckman Research Institute, 1500 East Duarte Road Duarte, CA, 91010, USA.
authors.forename: Marcia
authors.initials: M
authors.lastname: Grant
authors.affiliation: Kaiser Permanente Northwest, 3800 N. Interstate Ave., Portland, OR, 97227, USA.
authors.forename: Joanna E
authors.initials: JE
authors.lastname: Bulkley
authors.affiliation: Southern Arizona Veterans Affairs Health Care System, 3601 S. 6th Ave., Tucson, AZ, 85723, USA.|The University of Arizona College of Medicine, 1501 N. Campbell Ave., Tucson, AZ, 85724, USA.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Wendel
authors.affiliation: Southern Arizona Veterans Affairs Health Care System, 3601 S. 6th Ave., Tucson, AZ, 85723, USA.|The University of Arizona College of Medicine, 1501 N. Campbell Ave., Tucson, AZ, 85724, USA.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Krouse
mesh_terms: D000328:Adult; D000368:Aged; D000073116:Cancer Survivors / Q000523:psychology*; D017281:Cost of Illness; D003863:Depression / Q000191:economics / Q000523:psychology*; D005260:Female; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010030:Ostomy / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D012004:Rectal Neoplasms / Q000191:economics* / Q000523:psychology*; D057566:Self Report