Jeong S-M, Kang D, Kim H, Jeon K H, Choi H L, Park H Y, Kim S, Cho J, Shin D W
Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Center for Trend Monitoring-Risk Modeling, Samsung Medical Center, Seoul, Republic of Korea.
ESMO Open. 2025 Feb;10(2):104101. doi: 10.1016/j.esmoop.2024.104101. Epub 2025 Jan 27.
Although adolescent and young adult (AYA) cancer survivors have an increased risk of psychiatric disorders, limited evidence has been suggested. We aimed to determine the risk of psychiatric disorders among AYA cancer survivors.
A retrospective population-based cohort study based on the Korea National Health Insurance Service database was carried out. All men and women aged 15-39 years diagnosed with cancer between 2006 and 2019 (N = 88 965) were included and matched with controls (1 : 4). The prevalence ratios (PRs) of psychiatric disorders were calculated in cancer patients and compared with those in the control group every 6 months before and after cancer diagnosis.
The mean age of the participants was 32.2 years and the majority were 30-39 years of age (72.9%). There was no difference in the PRs of psychiatric disorders between AYA cancer patients and the control group before cancer diagnosis, but it increased sharply after cancer diagnosis [PR 2.50, 95% confidence interval (CI) 2.42-2.58 in the first 6 months]. During a median follow-up of 6.5 years, 54 733 participants developed psychiatric disorders. The overall risk of psychiatric disorders among AYA cancer survivors compared with the control group had a sub-distribution hazard ratio of 1.42 (95% CI 1.39-1.45) after considering competing risks.
Our study confirmed a 42% increased risk of psychiatric disorders among AYA cancer survivors compared with controls across various cancer types. Our findings suggest that AYA cancer survivors require long-term psychological support following their cancer diagnosis.
尽管青少年和青年癌症幸存者患精神疾病的风险增加，但相关证据有限。我们旨在确定青少年和青年癌症幸存者患精神疾病的风险。
基于韩国国民健康保险服务数据库开展了一项回顾性队列研究。纳入2006年至2019年间诊断为癌症的所有年龄在15 - 39岁之间的癌症患者（N = 88965），并与对照组按1:4进行匹配。计算癌症患者精神疾病的患病率，并在癌症诊断前后每6个月与对照组进行比较。
参与者的平均年龄为32.2岁，大多数为30 - 39岁（72.9%）。在癌症诊断前，青少年和青年癌症患者与对照组精神疾病的患病率无差异，但在癌症诊断后急剧上升[在最初6个月患病率为2.50，95%置信区间（CI）为2.42 - 2.58]。在中位随访6.5年期间，54733名参与者患精神疾病。在考虑竞争风险后，青少年和青年癌症幸存者患精神疾病的总体风险与对照组相比，亚分布风险比为1.42（95%CI为1.39 - 1.45）。
我们的研究证实，与对照组相比，青少年和青年癌症幸存者患精神疾病的风险增加了42%，涵盖各种癌症类型。我们的研究结果表明，青少年和青年癌症幸存者在癌症诊断后需要长期的心理支持。
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