Epidemiology and Health

Original Articles

Effect of chemotherapy and radiotherapy on cognitive impairment in colorectal cancer: evidence from Korean National Health Insurance Database Cohort: Kwanghyun Kim, Chang Woo Kim, Aesun Shin, Hyunseok Kang, Sun Jae Jung; Epidemiol Health. 2021;43:e2021093. Published online November 2, 2021; DOI: https://doi.org/10.4178/epih.e2021093

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
We investigated the risk of chemotherapy-related and radiotherapy-related cognitive impairment in colorectal cancer patients.

METHODS

Medical use data of colorectal cancer patients were obtained from the Korean National Health Insurance Database from 2004 to 2018. We randomly selected 40% of all colorectal cancer patients (n=148,848). Cognitive impairment was defined as having 1 or more International Classification of Diseases, 10th revision diagnostic codes for dementia or mild cognitive impairment. Patients aged 18 years or younger, patients diagnosed with cognitive impairment before colorectal cancer diagnosis (n=8,225), and patients who did not receive primary resection (n=45,320) were excluded. The effects of individual chemotherapy regimens on cognitive impairment were estimated. We additionally estimated the effect of radiotherapy in rectal cancer patients. Time-dependent competing risk Cox regression was conducted to estimate the overall and age-specific hazard ratios (HR) separately for colon and rectal cancer. Landmark analyses with different lag times were conducted as sensitivity analyses.

RESULTS

Chemotherapy did not increase the risk of cognitive impairment in colorectal cancer patients (colon cancer: HR, 0.92; 95% confidence interval [CI], 0.83 to 1.03; rectal cancer: HR, 0.88; 95% CI, 0.75 to 1.04), while radiotherapy was negatively associated with cognitive impairment in rectal cancer patients (HR, 0.01; 95% CI, 0.84 to 0.99). Varying directions of the associations between regimens and cognitive impairment were detected. The adverse effect of certain chemotherapy regimens on cognition was more prominent in older adults.

CONCLUSIONS

Chemotherapy and radiotherapy did not increase the risk of cognitive impairment. Older patients with low cognitive reserve could be affected by the adverse cognitive effects of chemotherapy.

Summary

Korean summary
- 대장암 환자를 대상으로 한 항암화학요법 및 방사선요법은 인지기능저하의 위험을 높이지 않았다 - 일부 항암화학요법의 경우 고령의 대장암 환자에서 인지기능저하의 위험을 증가시킬 수 있다

Key Message
Results from nationwide cohort of Korea showed that chemotherapy and radiotherapy did not increase the risk of cognitive impairment in colorectal cancer patients.

Citations

Citations to this article as recorded by

Research Progress: Exploring the Long-term Survival Status of Colorectal Cancer Survivors
Zhaobei Cai, Qianqian Chen, Enqiang Linghu
Clinical Cancer Investigation Journal.2024; 13(2): 34. CrossRef
Predictors of cognitive impairment in patients undergoing ileostomy for colorectal cancer: a retrospective analysis
Jing Xu, Yuelan Yang, Die Hu
PeerJ.2023; 11: e15405. CrossRef
Soluble HSPG and HS relaying neuroinflammation contribute to behavioral comorbidities associated with cancer located outside the central nervous system
Yue-peng Liu, Yan-jun Yang
Medical Hypotheses.2023; 177: 111113. CrossRef
Chemotherapy-induced functional brain abnormality in colorectal cancer patients: a resting‐state functional magnetic resonance imaging study
Siwen Liu, Yesong Guo, Jie Ni, Na Yin, Chenchen Li, Xuan Pan, Rong Ma, Jianzhong Wu, Shengwei Li, Xiaoyou Li
Frontiers in Oncology.2022;[Epub] CrossRef
Association between multimorbidity status and incident dementia: a prospective cohort study of 245,483 participants
He-Ying Hu, Ya-Ru Zhang, Qiaolifan Aerqin, Ya-Nan Ou, Zuo-Teng Wang, Wei Cheng, Jian-Feng Feng, Lan Tan, Jin-Tai Yu
Translational Psychiatry.2022;[Epub] CrossRef

The effects of information-seeking behaviours on prevention behaviours during the COVID-19 pandemic: the mediating effects of anxiety and fear in Korea: Kwanghyun Kim, Jisu Yang, Ye Jin Jeon, Yu Jin Lee, Youngrong Lee, Hyeon Chang Kim, Karestan Koenen, Yong-Chan Kim, Sun Jae Jung; Epidemiol Health. 2021;43:e2021085. Published online October 19, 2021; DOI: https://doi.org/10.4178/epih.e2021085

9,354 View
198 Download
6 Web of Science
6 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Identifying determinants of prevention behaviours during the emergence of a new infectious disease is important. We investigated the associations between information-seeking and prevention behaviours during the coronavirus disease 2019 (COVID-19) pandemic and mediating effects of psychiatric factors.

METHODS

In total, 1,970 participants from the Cardiovascular and Metabolic Etiology Research Center cohort participated in an online survey 55 days after the first COVID-19 case in Korea was diagnosed. Time spent seeking information related to COVID-19; information sources; psychiatric factors, including anxiety, depression, post-traumatic stress symptoms (PTSS), and the fear of COVID-19; and prevention behaviours were examined. The mediating effect of psychiatric factors was estimated using mediation analysis.

RESULTS

Time spent seeking information and information sources affected several behavioural responses. In men, anxiety mediated associations between information-seeking and prevention behaviours, including purchasing sanitary supplies (effect size [ES], 0.038; 95% confidence interval [CI], 0.002 to 0.095) and hoarding (ES, 0.029; 95% CI, 0.002 to 0.068). The fear of COVID-19 also mediated associations between information-seeking and prevention behaviours including refraining from going out (men: ES, 0.034; 95% CI, 0.009 to 0.068; women: ES, 0.052; 95% CI, 0.030 to 0.080), wearing face masks (men: ES, 0.085; 95% CI, 0.031 to 0.184), avoiding public transportation (men: ES, 0.020; 95% CI, 0.000 to 0.044; women: ES, 0.031; 95% CI, 0.015 to 0.051), hoarding (women: ES, 0.051; 95% CI, 0.029 to 0.792), and trying alternative remedies (men: ES, 0.024; 95% CI, 0.004 to 0.053). Depressive symptoms and PTSS did not have any mediating effects.

CONCLUSIONS

While the availability of information related to COVID-19 can help prevent infections, it can also promote anxiety and fear, leading to negative behaviours such as hoarding and trying unverified alternative treatments.

Summary

Korean summary
-본 연구는 한국인에서 코로나-19 관련 정보탐색이 예방 행동과 상관관계가 있는지를 확인하고 불안, 공포, 우울을 비롯한 심리 상태가 이 상관관계를 매개하는 메커니즘으로 작용하는지를 확인하고자 하였다. - 본 코호트 연구에서 정보 탐색 시간이 길어질수록 예방 행동을 취하는 빈도가 증가하였으며 불안 및 코로나-19에 대한 공포가 이 둘 사이의 상관관계를 일부 매개하였다. - 정보탐색이 증가할수록 외출 자제, 마스크 착용, 대중교통 이용 자제와 같은 권장되는 예방 행동을 취할 가능성도 증가하였지만 사재기를 하거나 검증되지 않은 대체요법에 의지하는 등 권장되지 않는 예방 행동을 취할 가능성 또한 같이 증가하였다.

Key Message
In this study, we tried to test the association between information-seeking behavior and preventive measures during COVID-19 pandemic. We also tried to understand whether psychologic factors such as anxiety, fear against COVID-19 and depression mediate the association. We found that time used for searching COVID-19-related information is positively associated with preventive behaviors, and that anxiety and fear mediate the association. Information seeking increased the probability of utilizing recommended prevention strategy such as wearing facial masks and refraining from going out, but also promoted prevention behavior not recommended by government officials such as hoarding and trying alternative remedies.

Citations

Citations to this article as recorded by

Protective behaviors against COVID-19 and their association with psychological factors in China and South Korea during the Omicron wave: a comparative study
J. Deng, M. Lee, C. Qin, Y. Lee, M. You, J. Liu
Public Health.2024; 229: 116. CrossRef
Coronavirus disease 2019 information-seeking behavior globally: a systematic review
Tadele Fentabil Anagaw, Habtamu Alganeh Guadie
SAGE Open Medicine.2023; 11: 205031212311535. CrossRef
“It Bothered Me”: The Mental Burden of COVID-19 Media Reports on Community-Dwelling Elderly People
Natasa Maksimovic, Tatjana Gazibara, Jelena Dotlic, Marija Milic, Vida Jeremic Stojkovic, Smiljana Cvjetkovic, Gordana Markovic
Medicina.2023; 59(11): 2011. CrossRef
Assessing Knowledge, Preventive Practices, and Depression Among Chinese International Students and Local Korean Students in South Korea During the COVID-19 Pandemic: An Online Cross-Sectional Study
Xiaoxu Jiang, Bo Zhao, Eun Woo Nam, Fanlei Kong
Frontiers in Psychiatry.2022;[Epub] CrossRef
Association between fear of COVID-19 and hoarding behavior during the outbreak of the COVID-19 pandemic: The mediating role of mental health status
Ye Zhao, Yang Yu, Ruofan Zhao, Yiming Cai, Shuai Gao, Ye Liu, Sheng Wang, Huifeng Zhang, Haiying Chen, Youdong Li, Haishui Shi
Frontiers in Psychology.2022;[Epub] CrossRef
Fear of COVID-19 and Prevention Behaviors: Cross-Lagged Panel Analysis
Katherine M Anderson, Jamila K Stockman
JMIR Formative Research.2022; 6(11): e35730. CrossRef

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