Risk of psychiatric disorders in long-term cancer survivors

Abstract

9577 Background: Although the physical, mental, and social stresses of surviving cancer may put cancer survivors at greater risk for developing a psychiatric disorder, few data exist on the risks of psychiatric disorders in cancer survivors. This study compares the rates of common psychiatric disorders between long-term cancer survivors and people without cancer histories in a nationally representative sample, the National Comorbity Survey-Replication (NCS-R). Methods: The NCS-R conducted face-to-face diagnostic psychiatric interviews between 2001–2002 in a national sample of 9,282 people ages 18 and older, assessing cancer histories in a sub-set of 5,692 participants. Estimates of the odds ratios for meeting diagnostic criteria for a psychiatric disorder in the last 12 months [major depressive disorder (MDD), generalized anxiety disorder (GAD), panic disorder (PD), and post-traumatic stress disorder (PTSD)] for long-term cancer survivors compared to those without a cancer history were obtained through multiple logistic regression analyses controlling for age, gender, race, education, household income, and marital status. Long-term cancer survivors were defined as respondents reporting a cancer diagnosis at least 5 years prior to the interview and being either ‘in remission‘ or ‘cured.‘ Because of the complex sampling, the final sample weights for the NCS-R were used in the analyses. Results: In the sample, 223 long-term cancer survivors and 5337 people who never had cancer were identified. Approximately 12.47% of the sample met criteria for a psychiatric disoder in the last 12 months. No difference was found between survivors and those without cancer histories, 12.21% and 12.50% respectively, with an adjusted odds ratio of 1.20 (95% CI 0.75–2.07). Additionally, cancer survivors were not found to have significantly higher adjusted odds of having specific disorder in the last 12 months: MDD OR=0.78 (95% CI 0.41, 1.51); GAD OR=1.18 (95% CI 0.64, 2.17); PD OR=.98 (95% CI 0.35, 2.71); and PTSD OR=1.51 (95% CI 0.81, 2.82). Conclusions: Although some previous studies have reported higher rates of psychiatric symptoms in cancer survivors, these symptoms may not be severe enough to meet diagnostic criteria for actual psychiatric disorders or may not fit into current diagnostic categories. No significant financial relationships to disclose.