Effect of mental disorders on diagnosis, treatment, and survival of older adults with colon cancer

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Abstract

OBJECTIVES: To evaluate the extent to which preexisting mental disorders influence diagnosis, treatment, and survival in older adults with colon cancer. DESIGN: Retrospective cohort study. SETTING: The Surveillance, Epidemiology and End Results (SEER)-Medicare linked database. PARTICIPANTS: Eighty thousand six hundred seventy participants, aged 67 and older with a diagnosis of colon cancer. MEASUREMENTS: The association between the presence of a preexisting mental disorder and the stage of colon cancer at diagnosis, receipt of cancer treatment, and overall and colon cancer-specific mortality were assessed using Cox proportional hazards regression and logistic regression. RESULTS: Participants with mental disorders were more likely to have been diagnosed with colon cancer at autopsy (4.4% vs 1.1%; P<.001) and at an unknown stage of cancer (14.6% vs 6.2%; P<.001); to have received no surgery, chemotherapy, or radiation therapy (adjusted risk ratio (ARR)=2.09, 95% confidence interval (CI)=1.86-2.35); and to have received no chemotherapy for Stage 3 cancer (ARR=1.63, 95% CI=1.49-1.79). The rate of overall mortality (hazard ratio (HR)=1.33, 95% CI=1.31-1.36) and colon cancer-specific mortality (HR=1.23, 95% CI=1.19-1.27) was substantially higher in participants with a preexisting mental disorder than in their counterparts. All of these associations were particularly pronounced in participants with psychotic disorders and those with dementia. CONCLUSION: Public health initiatives are needed to improve colon cancer detection and treatment in older adults with mental disorders.

Original languageEnglish (US)
Pages (from-to)1268-1273
Number of pages6
JournalJournal of the American Geriatrics Society
Volume59
Issue number7
DOIs
StatePublished - Jul 2011

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Mental Disorders
Colonic Neoplasms
Preexisting Condition Coverage
Confidence Intervals
Therapeutics
Mortality
Odds Ratio
Drug Therapy
Neoplasms
Medicare
Psychotic Disorders
Dementia
Autopsy
Epidemiology
Cohort Studies
Radiotherapy
Retrospective Studies
Public Health
Logistic Models
Databases

Keywords

  • access to care
  • colon cancer
  • mental health

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

@article{116e352589ec47019fd20c6061b0410b,
title = "Effect of mental disorders on diagnosis, treatment, and survival of older adults with colon cancer",
abstract = "OBJECTIVES: To evaluate the extent to which preexisting mental disorders influence diagnosis, treatment, and survival in older adults with colon cancer. DESIGN: Retrospective cohort study. SETTING: The Surveillance, Epidemiology and End Results (SEER)-Medicare linked database. PARTICIPANTS: Eighty thousand six hundred seventy participants, aged 67 and older with a diagnosis of colon cancer. MEASUREMENTS: The association between the presence of a preexisting mental disorder and the stage of colon cancer at diagnosis, receipt of cancer treatment, and overall and colon cancer-specific mortality were assessed using Cox proportional hazards regression and logistic regression. RESULTS: Participants with mental disorders were more likely to have been diagnosed with colon cancer at autopsy (4.4{\%} vs 1.1{\%}; P<.001) and at an unknown stage of cancer (14.6{\%} vs 6.2{\%}; P<.001); to have received no surgery, chemotherapy, or radiation therapy (adjusted risk ratio (ARR)=2.09, 95{\%} confidence interval (CI)=1.86-2.35); and to have received no chemotherapy for Stage 3 cancer (ARR=1.63, 95{\%} CI=1.49-1.79). The rate of overall mortality (hazard ratio (HR)=1.33, 95{\%} CI=1.31-1.36) and colon cancer-specific mortality (HR=1.23, 95{\%} CI=1.19-1.27) was substantially higher in participants with a preexisting mental disorder than in their counterparts. All of these associations were particularly pronounced in participants with psychotic disorders and those with dementia. CONCLUSION: Public health initiatives are needed to improve colon cancer detection and treatment in older adults with mental disorders.",
keywords = "access to care, colon cancer, mental health",
author = "Jacques Baillargeon and Kuo, {Yong Fang} and Lin, {Yu Li} and Mukaila Raji and Amanpal Singh and James Goodwin",
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T1 - Effect of mental disorders on diagnosis, treatment, and survival of older adults with colon cancer

AU - Baillargeon, Jacques

AU - Kuo, Yong Fang

AU - Lin, Yu Li

AU - Raji, Mukaila

AU - Singh, Amanpal

AU - Goodwin, James

PY - 2011/7

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N2 - OBJECTIVES: To evaluate the extent to which preexisting mental disorders influence diagnosis, treatment, and survival in older adults with colon cancer. DESIGN: Retrospective cohort study. SETTING: The Surveillance, Epidemiology and End Results (SEER)-Medicare linked database. PARTICIPANTS: Eighty thousand six hundred seventy participants, aged 67 and older with a diagnosis of colon cancer. MEASUREMENTS: The association between the presence of a preexisting mental disorder and the stage of colon cancer at diagnosis, receipt of cancer treatment, and overall and colon cancer-specific mortality were assessed using Cox proportional hazards regression and logistic regression. RESULTS: Participants with mental disorders were more likely to have been diagnosed with colon cancer at autopsy (4.4% vs 1.1%; P<.001) and at an unknown stage of cancer (14.6% vs 6.2%; P<.001); to have received no surgery, chemotherapy, or radiation therapy (adjusted risk ratio (ARR)=2.09, 95% confidence interval (CI)=1.86-2.35); and to have received no chemotherapy for Stage 3 cancer (ARR=1.63, 95% CI=1.49-1.79). The rate of overall mortality (hazard ratio (HR)=1.33, 95% CI=1.31-1.36) and colon cancer-specific mortality (HR=1.23, 95% CI=1.19-1.27) was substantially higher in participants with a preexisting mental disorder than in their counterparts. All of these associations were particularly pronounced in participants with psychotic disorders and those with dementia. CONCLUSION: Public health initiatives are needed to improve colon cancer detection and treatment in older adults with mental disorders.

AB - OBJECTIVES: To evaluate the extent to which preexisting mental disorders influence diagnosis, treatment, and survival in older adults with colon cancer. DESIGN: Retrospective cohort study. SETTING: The Surveillance, Epidemiology and End Results (SEER)-Medicare linked database. PARTICIPANTS: Eighty thousand six hundred seventy participants, aged 67 and older with a diagnosis of colon cancer. MEASUREMENTS: The association between the presence of a preexisting mental disorder and the stage of colon cancer at diagnosis, receipt of cancer treatment, and overall and colon cancer-specific mortality were assessed using Cox proportional hazards regression and logistic regression. RESULTS: Participants with mental disorders were more likely to have been diagnosed with colon cancer at autopsy (4.4% vs 1.1%; P<.001) and at an unknown stage of cancer (14.6% vs 6.2%; P<.001); to have received no surgery, chemotherapy, or radiation therapy (adjusted risk ratio (ARR)=2.09, 95% confidence interval (CI)=1.86-2.35); and to have received no chemotherapy for Stage 3 cancer (ARR=1.63, 95% CI=1.49-1.79). The rate of overall mortality (hazard ratio (HR)=1.33, 95% CI=1.31-1.36) and colon cancer-specific mortality (HR=1.23, 95% CI=1.19-1.27) was substantially higher in participants with a preexisting mental disorder than in their counterparts. All of these associations were particularly pronounced in participants with psychotic disorders and those with dementia. CONCLUSION: Public health initiatives are needed to improve colon cancer detection and treatment in older adults with mental disorders.

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