PCN39 - Patterns of Post-Diagnosis Depression Among Late-Stage Cancer Patients: Do Racial/Ethnic and Gender Disparities Exist?

Abstract

Depression is a heterogeneous mental health disorder but also the most treatable of all mental disorders. As one of the common illnesses among cancer patients, the demographic profile on the incidence of depression after a late-stage cancer diagnosis is still poorly understood and has not been the subject of intense investigation. We used population-based data to examine trends in post-diagnosis depression incidence among racial/ethnic groups and sexes. We identified 123,244 patients diagnosed with late-stage breast, prostate, lung, or colorectal cancer from 2001 to 2013 in the SEER Medicare-linked database. The primary outcome was the incidence of post-diagnosis depression after a late-stage cancer diagnosis. Trend analysis was performed using the Cochran-Armitage test for trend. Stratified incidence rates were calculated for the racial/ethnic and sex groups. Among late-stage cancer patients, the incidence of depression after cancer diagnosis increased from 13.2% in 2001 to 21.4% in 2013, Ptrend < 0.0001. 16,945 (17.1%) non-Hispanic whites, 1,625 (13.3%) non-Hispanic blacks, and 550 (10.7%) Hispanics were diagnosed with depression during a mean follow-up of 6.6 months (IQR: [2.7; 17.2] months).The incidence of depression is significantly higher among females than males, 19.3% versus 13.9%, P < 0.0001. In the multivariable logistic regression, non-Hispanic whites and female were still independent predictors of post-diagnosis depression. There are significant differences in the incidence of post-diagnosis depression among racial/ethnic groups in the United States. The study also suggests that females were more frequently diagnosed with depression than males after a late-stage cancer diagnosis. Further research is needed to explain these observed and remarkable differences among the different racial/ethnic groups and sexes. The consideration of racial/ethnic and gender status in depression prevention and diagnosis among cancer patients should be discussed as a matter of importance to ensure that there is no diagnosis bias among men, non-Hispanic blacks, and Hispanics.