In a Canadian study reported in the Journal of Clinical Oncology, Oberoi et al found that adolescents and young adults (AYAs) with cancer were at an increased risk of mental disorders compared with cancer-free matched population-based and sibling cohorts.
Study Details
The retrospective population-based study involved data from 3,818 AYAs diagnosed with cancer at age 15 to 39 years between 1989 and 2019. Outcomes consisted of incidence of mood and anxiety disorders, substance use disorders, suicide outcomes, psychotic disorders, and any of the preceding four categories within 5 years of their cancer diagnosis. Outcomes were compared with those in 9,068 matched AYA individuals in a cancer-free population-based cohort and between 1,707 AYAs with cancer matched to 1,707 AYA cancer-free siblings.
Key Findings
AYAs with cancer were more likely to be diagnosed with incident mental disorders vs the population-based cancer-free cohort. Risk was highest soon after cancer diagnosis and decreased over time.
The significant adjusted subhazard ratios were:
- 11.27 (95% confidence interval [CI] = 6.69–18.97) at 0 to 6 months, 2.35 (95% CI = 1.54–3.58) at 6 to 12 months, and 2.06 (95% CI = 1.55–2.75) at 12 to 24 months for mood and anxiety disorders
- 2.73 (95% CI = 1.90–3.92) for substance use disorders at 0 to 6 months
- 4.69 (95% CI = 2.07–10.65) for psychotic disorders at 0 to 6 months
- 4.46 (95% CI = 3.41–5.85), at 0 to 6 months, 1.56 (95% CI = 1.14–2.14) at 6 to 12 months, and 1.7 (95% CI = 1.36–2.13) at 12 to 24 months for any mental disorder.
In the matched sibling comparison, significant subhazard ratios for AYAs with cancer were 11.0 (95% CI = 2.6–46.5) for mood and anxiety disorders and 4.0 (95% CI = 2.1–7.7) for any mental disorder during the first 6 months after cancer diagnosis.
The investigators concluded, “AYAs with cancer experience a greater incidence of mental disorders after cancer diagnosis relative to population-based and sibling cohorts without cancer, primarily within [the] first 2 years, underscoring the need to address mental health concerns during this period.”
Sapna Oberoi, MD, DM, of CancerCare Manitoba, Winnipeg, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: The study was supported by the Manitoba Medical Services Foundation and Winnipeg Foundation. For full disclosures of the study authors, visit ascopubs.org.
