Abstract
INTRODUCTION: Cancer diagnoses are associated with considerable psychological distress and increased incidence of new mental health disorders (MHDs). Our aim was to identify patterns and differences in the emergence of new MHDs within the first year following a cancer diagnosis, using data from a diverse, multi-institutional cancer cohort including more than half a million patients within a statewide academic health system. METHODS: The University of California Data Discovery Platform was used, which aggregates data of all patients at University of California-affiliated hospitals. We identified a cohort consisting of all adult patients with a cancer diagnosis and no documented MHDs before cancer diagnosis between 2013 and 2023. Multivariable adjusted time-partitioned hazard ratios for overall all-cause mortality were constructed using epochs of 12 through 35, 36 through 59, and 60 through 120 months. RESULTS: A total of 371,897 patients (mean age, 62.1 years) did not have a diagnosis. Following an incident cancer diagnosis, 39,687 patients (10.6%) developed a new MHD within a year. Of these, 13,904 (35.0%) were newly prescribed one or more oral psychotropic medications. After adjusting for covariates, early MHD was found to be linked to increased all-cause mortality in the initial 12 through 35 months (hazard ratio, 1.51; 95% CI, 1.47-1.56), which diminished over time, observed as 1.17 (95% CI, 1.11-1.24) for 36 through 59 months and 0.95 (95% CI, 0.89-1.01) for 60 through 120 months. CONCLUSIONS: Patients with cancer who experience a mental health condition are at an increased risk of all-cause mortality. This reinforces and emphasizes existing recommendations for prompt screening and management of distress and mental health following a cancer diagnosis.