Incidence of Depression and Anxiety in Kidney Cancer Survivors: A Nationwide Population-Based Cohort Study

Abstract Background: Depression and anxiety have a high prevalence among kidney cancer survivors. We aimed to evaluate their cumulative incidence trajectories and associations between kidney cancer diagnosis and incidence of these conditions. Methods: This population-based cohort study used the Korean Nationwide Health Insurance and Medical Checkup Linkage Database. We included adults (≥20 years) diagnosed with kidney cancer (2010–2020; i.e., cancer survivors), along with age- and sex-matched noncancer comparators. We quantified the empirical risk trajectory of depression and anxiety for up to 5 years following diagnosis and conducted weighted Cox regressions to estimate time-dependent HRs with 95% confidence intervals (CI) within three time intervals: 0 to 1, 1 to 3, and 3 to 5 years. Results: For the empirical risks, survivors (n = 24,310) had higher risks of depression (2.8% vs. 2.2%) and anxiety (3.3% vs. 2.6%) compared with comparators (n = 173,471). For the associations, survivors (n = 16,049) had an increased hazard of depression (HR = 1.92; 95% CI, 1.52–2.42) and anxiety (HR = 1.63; 95% CI, 1.31–2.02) compared with comparators (n = 100,782) in the first year. During the subsequent 1 to 3 years, survivors experienced an increased hazard of anxiety (HR = 1.32; 95% CI, 1.07–1.62). Trends of decreasing HRs for both disorders were observed across successive time intervals. Conclusions: Kidney cancer survivors had a higher rate of depression and anxiety, especially during the early phase following diagnosis, compared with the noncancer population. Impact: Our findings emphasize the need for early identification and treatment of psychiatric disorders, highlighting the integration of mental health care into oncology settings. They also inform future research on prevention and treatment strategies, focusing on timing and high-risk groups.