Effects of Hospice Care on Anxiety, Depression, and Pain in Patients With Terminal Colon Adenocarcinoma: A Retrospective Cohort Study

Abstract

Background: Terminal colon adenocarcinoma is a debilitating condition often accompanied by severe pain and substantial anxiety and depression. Hospice care provides a dedicated framework to address this symptom complex, yet robust evidence for its real-world effectiveness within the Chinese healthcare context remains underdeveloped and insufficiently documented. This study aimed to evaluate the effects of hospice care on key clinical outcomes in terminal colon adenocarcinoma.

Methods: This retrospective cohort analysis reviewed data from 92 patients with histologically confirmed terminal colon adenocarcinoma (≥stage Ⅲ) treated at The Affiliated Yangming Hospital of Ningbo University between January 2024 and June 2025. The cohort included 46 patients receiving integrated hospice care alongside standard oncology treatment and 46 matched controls receiving standard care only. Comparative analyses of depression (Hospital Anxiety and Depression Scale–Depression, HADSD), anxiety (HADS-A), pain (visual analogue scale, VAS), opioid usage, and healthcare utilisation were conducted at baseline, 1, 3, and 6 months.

Results: Baseline characteristics were comparable between groups. HADS-D scores decreased more in the hospice care group (from 9.13 ± 3.39 to 5.91 ± 2.72) than in the standard group (from 9.35 ± 3.58 to 8.57 ± 3.04; p < 0.001). HADS-A scores showed a greater reduction in the hospice care group (from 8.63 ± 2.55 to 5.83 ± 2.57) than in the standard group (from 9.13 ± 3.17 to 8.48 ± 2.63; p< 0.001). The hospice care group demonstrated significantly greater reductions in VAS scores (from 6.83 ± 1.19 to 3.17 ± 1.01) compared with the standard group (from 6.74 ± 1.40 to 5.51 ± 1.63; p < 0.001) and a higher proportion achieved ≥30% pain reduction at 6 months(80.43% vs. 39.13%, p < 0.001). Additionally, hospice care was associated with lower opioid consumption, shorter hospital stays, fewer emergency visits, and reduced re-admissions (all p < 0.05), with no increase in adverse events.

Conclusions: For patients with terminal colon adenocarcinoma, integrated hospice care was associated with significantly improved pain control and reduced anxiety and depressive symptoms. It was also associated with decreased healthcare utilisation with a favourable safety profile.