In the Journals

Mental health disorders more common after head and neck cancer diagnosis

Findings from a cohort study of more than 52,000 patients diagnosed with head and neck cancer revealed that the prevalence of mental health disorders increased after they received the cancer diagnosis.

Although prior research has found a link between mental health disorders (MHDs) and head and neck cancer (HNC), large-scale analysis is needed, Neerav Goyal, MD, MPH, from the division of otolaryngology–head and neck surgery, Pennsylvania State University College of Medicine, and colleagues wrote.

Using a retrospective cohort design, the researchers reported the prevalence of mental health disorders in patients with head and neck cancer and any connections with survival and recurrence by analyzing 2005 to 2014 data from MarketScan, a large, U.S. insurance claims database.

They evaluated data from 52,641 patients with head and neck cancer, only including patients if they were in the database for at least 1 year prior to the index diagnosis and were continuously enrolled. Goyal and colleagues compared the frequency of mental health disorders before and after diagnosis of head and neck cancer.

Image of throat cancer 
Mental health disorders were more common in patients with head and neck cancer after they received the diagnosis than before, according to study findings.
Source: Adobe Stock

The investigators found that the prevalence of mental health disorders before head and neck cancer diagnosis was 20.6% (n = 10,847), but this increased to 29.9% (n = 15,763) after cancer diagnosis among the study participants.

Analysis revealed that women (adjusted OR = 1.58; 95% CI, 1.49-1.67), patients with a history of tobacco use (aOR = 1.42; 95% CI, 1.34-1.5) and those with a history of alcohol use (aOR = 1.56; 95% CI, 1.38-1.76) were significantly more likely to have a mental health disorder after head and neck cancer diagnosis.

Although oral cavity cancers were the most common type of head and neck cancer in the cohort (40.4%), patients with cancer of the trachea were twice as likely to develop mental illness than patients with cancer of the oral cavity (OR = 2.11; 95% CI, 1.87-2.38). Those with cancer of the nasopharynx (OR = 1.22; 95% CI, 1.14-1.31) and hypopharynx (OR = 1.21; 95% CI, 1.1-1.33) were also at higher risk for mental health disorders than those with oral cavity cancer.

“Patients with HNC demonstrate a robust association with MHDs. High mortality and morbidity associated with HNCs may predispose these patients to MHDs,” Goyal and colleagues wrote. “Discriminating the differential effects of treatment modalities on the development of MHDs based on our results alone is difficult. However, our results further support the importance of addressing psychosocial needs in routine treatment discussions.” – by Savannah Demko

Disclosure: One author reports personal fees from NICO Corporation and consulting for Medtronic, Inc. No other authors reported relevant financial disclosures.

Findings from a cohort study of more than 52,000 patients diagnosed with head and neck cancer revealed that the prevalence of mental health disorders increased after they received the cancer diagnosis.

Although prior research has found a link between mental health disorders (MHDs) and head and neck cancer (HNC), large-scale analysis is needed, Neerav Goyal, MD, MPH, from the division of otolaryngology–head and neck surgery, Pennsylvania State University College of Medicine, and colleagues wrote.

Using a retrospective cohort design, the researchers reported the prevalence of mental health disorders in patients with head and neck cancer and any connections with survival and recurrence by analyzing 2005 to 2014 data from MarketScan, a large, U.S. insurance claims database.

They evaluated data from 52,641 patients with head and neck cancer, only including patients if they were in the database for at least 1 year prior to the index diagnosis and were continuously enrolled. Goyal and colleagues compared the frequency of mental health disorders before and after diagnosis of head and neck cancer.

Image of throat cancer 
Mental health disorders were more common in patients with head and neck cancer after they received the diagnosis than before, according to study findings.
Source: Adobe Stock

The investigators found that the prevalence of mental health disorders before head and neck cancer diagnosis was 20.6% (n = 10,847), but this increased to 29.9% (n = 15,763) after cancer diagnosis among the study participants.

Analysis revealed that women (adjusted OR = 1.58; 95% CI, 1.49-1.67), patients with a history of tobacco use (aOR = 1.42; 95% CI, 1.34-1.5) and those with a history of alcohol use (aOR = 1.56; 95% CI, 1.38-1.76) were significantly more likely to have a mental health disorder after head and neck cancer diagnosis.

Although oral cavity cancers were the most common type of head and neck cancer in the cohort (40.4%), patients with cancer of the trachea were twice as likely to develop mental illness than patients with cancer of the oral cavity (OR = 2.11; 95% CI, 1.87-2.38). Those with cancer of the nasopharynx (OR = 1.22; 95% CI, 1.14-1.31) and hypopharynx (OR = 1.21; 95% CI, 1.1-1.33) were also at higher risk for mental health disorders than those with oral cavity cancer.

“Patients with HNC demonstrate a robust association with MHDs. High mortality and morbidity associated with HNCs may predispose these patients to MHDs,” Goyal and colleagues wrote. “Discriminating the differential effects of treatment modalities on the development of MHDs based on our results alone is difficult. However, our results further support the importance of addressing psychosocial needs in routine treatment discussions.” – by Savannah Demko

Disclosure: One author reports personal fees from NICO Corporation and consulting for Medtronic, Inc. No other authors reported relevant financial disclosures.