Villalona Seiichi, Perez Carlos Chavez, Wileyto E Paul, Takvorian Samuel, Gabriel Peter, Doucette Abigail, Blumenthal Daniel, Schnoll Robert
Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Department of Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Psychooncology. 2024 Dec;33(12):e70046. doi: 10.1002/pon.70046.
The diagnosis of a mood-related psychiatric disorder (MRPD) among patients with cancer has been associated with decreased quality of life and lower cancer survival. This study aimed to understand the risk of a new MRPD after cancer diagnosis by individual risk behaviors, with a specific focus on tobacco use and the presence of a human papillomavirus (HPV)-associated cancer.
Single-center retrospective cohort study of 11,712 patients diagnosed with cancer between 2009 and 2020. We identified predictors of a new MRPD after cancer diagnosis using a time-to-event analysis and Cox proportional hazards model including demographics, disease characteristics, and tobacco use and HPV-associated tumors.
Univariate analyses revealed lower hazard ratios (HRs) of a new MRPD among individuals that identified as Asian/Pacific Islanders and among the older age groups (> 51 years). Univariate analyses additionally demonstrated higher HRs of MRPD among females; sexual minorities; former and current smokers; individuals with HPV-associated cancers; and individuals diagnosed at later stages. These relationships were observed in the multivariate model when adjusting for covariates. Shorter time-to-MRPD was observed when stratifying by individual behavioral risk factors, with active smokers and individuals with an HPV-associated cancer being at the highest risk.
Individual behavioral risk factors increase risk of new MRPD after being diagnosed with cancer. These findings build on past studies by linking tobacco use and HPV-associated cancers with MRPD risk in oncology and can be used to identify patients at risk of developing new MRPDs post-cancer diagnosis and engaging them in treatment.
癌症患者中与情绪相关的精神障碍（MRPD）的诊断与生活质量下降和癌症生存率降低有关。本研究旨在通过个体风险行为了解癌症诊断后发生新的MRPD的风险，特别关注烟草使用和人乳头瘤病毒（HPV）相关癌症的存在情况。
对2009年至2020年间诊断为癌症的11712例患者进行单中心回顾性队列研究。我们使用事件发生时间分析和Cox比例风险模型确定癌症诊断后新的MRPD的预测因素，该模型包括人口统计学、疾病特征、烟草使用和HPV相关肿瘤。
单因素分析显示，在认定为亚裔/太平洋岛民的个体以及年龄较大的年龄组（>51岁）中，新的MRPD的风险比（HRs）较低。单因素分析还表明，女性、性少数群体、既往和当前吸烟者、患有HPV相关癌症的个体以及晚期诊断的个体中MRPD的HRs较高。在调整协变量后的多变量模型中也观察到了这些关系。按个体行为风险因素分层时，观察到MRPD的发生时间较短，其中现吸烟者和患有HPV相关癌症的个体风险最高。
个体行为风险因素会增加癌症诊断后发生新的MRPD的风险。这些发现基于以往的研究，将烟草使用和HPV相关癌症与肿瘤学中的MRPD风险联系起来，可用于识别癌症诊断后有发生新的MRPD风险的患者并使其接受治疗。
