Highlights
- •A diagnosis of bladder cancer increases the hazard of being diagnosed with a new mental health disorder.
- •Patients who are diagnosed with a new mental health disorder after their cancer diagnosis have worse overall survival.
- •The most common mental health disorders among those with a new bladder cancer diagnosis are depression, substance abuse, and anxiety.
Abstract
Background
To examine differences in survival outcomes for muscle-invasive bladder cancer patients
stratified by new mental health diagnosis.
Methods
Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare data, we identified
patients diagnosed with muscle-invasive bladder cancer between 2008 and 2014. Our
primary outcome was cancer-specific and overall hazards of mortality. As a secondary
outcome, we reported predictors of developing a new mental health diagnosis after
bladder cancer diagnosis. We used Cox proportional hazards models to determine the
impact of palliative care and mental health diagnoses on survival outcomes after adjusting
for grade, stage, comorbidity index, and baseline demographics.
Results
Of the 3794 patients who met inclusion criteria, 1193 (31%) were diagnosed with a
mental health illness after their bladder cancer diagnosis during the 6 years in the
study period. The most common diagnoses were depression (13%), alcohol and drug abuse
(12%), and anxiety (11%). Patients with a post-bladder cancer mental health diagnosis
had a 57% higher hazard of overall mortality (HR 1.57, P = .048) and an 80% higher hazard of bladder cancer-specific mortality (HR 1.81, P = .037)
Conclusions
New mental health diagnoses are associated with worse survival in patients with muscle
invasive bladder cancer. This suggests that a multimodal approach to bladder cancer
treatment should include addressing the non-oncologic needs of the patient to optimize
survival outcomes.
Keywords
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Article Info
Publication History
Published online: November 01, 2022
Accepted:
October 24,
2022
Received in revised form:
October 11,
2022
Received:
August 29,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
