The Impact of Preexisting Mental Health Disorders on the Diagnosis, Treatment, and Survival among Lung Cancer Patients in the U.S. Military Health System

Lin, Jie; McGlynn, Katherine A.; Carter, Corey A.; Nations, Joel A.; Anderson, William F.; Shriver, Craig D.; Zhu, Kangmin

doi:10.1158/1055-9965.epi-16-0316

Cited by 28 publications

(40 citation statements)

References 57 publications

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“…Twenty-eight studies were included in this review and 24 in the meta-analysis (figure 1). Twenty-three studies were identified from 2381 possible MEDLINE citations6–11 13 17 39–53 and an additional five articles were identified through the PubMed search and a manual search of narrative review references 12 16 18 19 54. Sixteen studies investigated stage at diagnosis and 25 investigated survival.…”

Section: Resultsmentioning

confidence: 99%

“…The majority of evidence supporting a greater risk of cancer-related death is based on a comparison of mortality rates in individuals with a psychiatric illness to a non-psychiatric population. Higher case-fatality rates have been reported in the few studies of cancer populations 6–19. Fewer studies have looked at cancer-specific death, which is important given the considerably higher baseline risk for death from non-cancer causes.…”

Section: Introductionmentioning

confidence: 99%

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Stage at diagnosis and survival in patients with cancer and a pre-existing mental illness: a meta-analysis

Davis

Bogner

Coburn

et al. 2019

J Epidemiol Community Health

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IntroductionIndividuals with a pre-existing mental illness, especially those experiencing reduced social, occupational and functional capacity, are at risk for cancer care disparities. However, uncertainty surrounding the effect of a mental illness on cancer outcomes exists.MethodsWe conducted a systematic review and meta-analysis of observational studies using MEDLINE and PubMed from 1 January 2005 to 1 November 2018. Two reviewers evaluated citations for inclusion. Advanced stage was defined as regional, metastatic or according to a classification system. Cancer survival was defined as time survived from cancer diagnosis. Pooled ORs and HRs were presented. The Newcastle-Ottawa bias risk assessment scale was used. Random-effects models used the Mantel-Haenszel approach and the generic inverse variance method. Heterogeneity assessment was performed using I2.Results2381 citations were identified; 28 studies were included and 24 contributed to the meta-analysis. Many demonstrated methodological flaws, limiting interpretation and contributing to significant heterogeneity. Data source selection, definitions of a mental illness, outcomes and their measurement, and overadjustment for causal pathway variables influenced effect sizes. Pooled analyses suggested individuals with a pre-existing mental disorder have a higher odds of advanced stage cancer at diagnosis and are at risk of worse cancer survival. Individuals with more severe mental illness, such as schizophrenia, are at a greater risk for cancer disparities.DiscussionThis review identified critical gaps in research investigating cancer stage at diagnosis and survival for individuals with pre-existing mental illness. High-quality research is necessary to support quality improvement for the care of psychiatric patients and their families during and following a cancer diagnosis.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Stage at diagnosis and survival in patients with cancer and a pre-existing mental illness: a meta-analysis

Davis

Bogner

Coburn

et al. 2019

J Epidemiol Community Health

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“…Most studies have found increased all-cause [2,8,[10][11][12][13][14][15][16][17] and cancer-specific mortality [18,19] among lung cancer patients with SMI, while some have reported difference in neither. [16,20,21] These conflicting results may reflect differences in study populations, designs and definitions.…”

Section: Introductionmentioning

confidence: 99%

The impact of severe mental illness on lung cancer mortality of patients with lung cancer in Finland in 1990–2013: a register-based cohort study

Arffman

Manderbacka

Suvisaari

et al. 2019

European Journal of Cancer

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Background While the link between severe mental illness (SMI) and elevated cancer mortality is well established, few studies have examined lung cancer survival and SMI in detail. Our study compared cancer-specific mortality in lung cancer patients with and without a history of SMI, and whether mortality differences could be explained by cancer stage at presentation, comorbidity or differences in cancer treatment. Methods We identified patients with their first lung cancer diagnosis in 1990-2013 from the Finnish Cancer Registry, their preceding hospital admissions due to SMI from the Hospital Discharge Register and deaths from the Causes of Death statistics. Competing risk analyses were used to estimate hazard ratios (HR) for the impact of SMI on mortality. Results Out of the 37,852 lung cancer cases, 12% had a history of SMI. Cancer-specific mortality differences were found between patient groups in some cancer types after controlling for stage at representation and treatment. Men with history of psychosis had excess mortality risk (HR 1.24, 1.06-1.45) in squamous cell carcinoma. Similar excess risk was found among women with psychosis in small-cell carcinoma (HR=1.76, 1.41-2.19) and in squamous cell carcinoma (HR=1.67, 1.26-2.20) and among women with mood disorders in adenocarcinoma (HR=1.37, 1.08-1.74). Patient group differences in HRs in five-year mortality did not markedly change from the 1990s. Conclusions We found elevated cancer-specific mortality among persons with a history of SMI. Collaboration between patients, mental health care professionals, and oncological teams is needed to reduce the mortality gap between cancer patients with and without SMI.

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“…Several scientific studies have been published regarding the prognosis of patients with cancer and MD, [5][6][7][8][9]11 most of which conclude that the presence of a MD increases the risk of cancer-related death. However, the aforementioned publications were all population-based studies using large databases.…”

Section: Discussionmentioning

confidence: 99%

Relationship between preexisting mental disorders and prognosis of gynecologic cancers: A case–control study

Tamauchi

Kajiyama

Moriyama

et al. 2019

J of Obstet and Gynaecol

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Aim Cancer treatment involves long‐term therapy and follow‐up, with mental disorders (MD) often affecting the treatment process. Hence, in this study, we retrospectively analyze cases involving gynecologic cancer with MD and clarify the relationship between psychosis and cancer prognosis. Methods Patients with both gynecologic cancer and MD from January 2003 to August 2016 were recruited in this study. Cases were limited to those whose MD had been diagnosed before their cancer. Control patients without MD were also analyzed. Both cases and controls were adjusted for age, cancer type, and cancer stage. Results A total of 54 patients with gynecologic cancer and MD, as well as 108 controls without MD, were included. The median age of the patients was 52 years. Details regarding cancer type were as follows: 11 ovarian cancers, 26 uterine corpus cancers and 17 cervical cancers. Among these, 25 schizophrenia cases, 15 depressive disorders, 4 bipolar disorders and 10 other MD were recorded. No significant differences in the 5‐year survival rate were found between patients and controls. In advanced‐stage cervical cancer, however, the prognosis was significantly poor given the low rate of initial treatment completion. Moreover, patients with advanced‐stage cervical cancer had significantly lower chemotherapy completion rates compared to those with other gynecologic malignancies. Conclusion Mental disorders do not affect the prognosis of gynecologic cancers, except for advanced cervical cancer. Accordingly, improving the low rate of initial treatment completion seems to be a focal point for better prognosis in advanced cervical cancer.

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The Impact of Preexisting Mental Health Disorders on the Diagnosis, Treatment, and Survival among Lung Cancer Patients in the U.S. Military Health System

Cited by 28 publications

References 57 publications

Stage at diagnosis and survival in patients with cancer and a pre-existing mental illness: a meta-analysis

Stage at diagnosis and survival in patients with cancer and a pre-existing mental illness: a meta-analysis

The impact of severe mental illness on lung cancer mortality of patients with lung cancer in Finland in 1990–2013: a register-based cohort study

Relationship between preexisting mental disorders and prognosis of gynecologic cancers: A case–control study

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