Longitudinal trajectories of depression and quality of life in a cohort of cancer survivors and individuals without cancer in Europe

Background: The long-term effects of cancer on psychological symptoms and quality of life (QoL) have been widely reported, but they were seldom examined over time compared to the general population. Aims: To investigate trajectories of depression and QoL over time among cancer survivors compared to individuals without cancer throughout Europe and identify associated factors. Methods: Data from five waves of the Survey of Health, Ageing and Retirement in Europe study were used. The study sample featured 1066 cancer survivors and 9655 individuals without cancer from 13 European countries. Group-based trajectory modeling was used to identify depression and QoL trajectories, and a linear mixed-effects model was used to characterize their correlates. Results: Four depression trajectories—stable low, stable high, increasing, and decreasing—and four QoL trajectories were identified. All QoL trajectories were stable over time, but differed in their levels: low, low-medium, medium–high, and high. Depression and QoL trajectories were similar between cancer survivors and individuals without cancer. However, significantly more cancer survivors had high-depression and low-QoL trajectories. Further, better perceived health, activities of daily living, physical activity, and income adequacy levels were significantly associated with changes in depression and QoL levels over time. Conclusions: Although depression and QoL trajectories did not differ between cancer survivors and individuals without cancer, more cancer survivors were characterized by high-depression and low-QoL life trajectories. Implications for Cancer Survivors: Providers should be aware and screen for cancer survivors with elevated depression and low QoL, and promote relevant psychosocial interventions. Modifiable factors associated with depression and QoL can be targets for cancer survivors’ long-term care plans.