Date of Conferral

2023

Degree

Ph.D.

School

Public Health

Advisor

Hadi Danawi

Abstract

AbstractColorectal cancer (CRC) is a life-threatening health condition known to greatly affect the elderly than younger populations. CRC, if comorbid with mental condition such as depression, can seriously affect patients’ quality of life with a direct influence on the survival rate. There is a connection between depression and worsened cancer progression and survival rate of CRC, little is known on gender differences in survival rates on elderly CRC patients with pre-existing depression (PD). A socioeconomic model study was used to evaluate gender, initial diagnostic stage, and marital status (MS) at diagnosis as major independent variables and 5-years survival rate (5-YS) as the dependent variable for this retrospective study. Upon evaluating secondary data from SEER Medicare with total sample size of 28,278 patients, the 5-YS rate for women (35.8 %) and men (30.8 %) was significantly different as per Log Rank test (p <0.001). Further, Cox proportional hazard model (p<0.001) showed association between gender and 5-YS rates for elderly CRC patients with PD with Hazard ratio (HR) and 95% CI as 0.891(0.865, 0.919). There is also a significant difference in 5-YS between men and women for initial stage of diagnosis (I, II and III) with HR and 95% CI of 0.754 (0.688, 0.826), 0.823 (0.758, 0.894), 0.827 (0.759, 0.902) respectively but not at Stage IV. Recommendations include establishing gender specific treatment approaches for populations dealing with mental disease and terminal illness, creating a strong foundation for gender-based intervention in psycho-oncology. The positive social change of this study is to have a strong advocacy on development of gender specific treatment strategies and protocols if life ending condition such as cancer is comorbid with mental condition like depression.

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