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Comparative Study
. 2011 Jul;59(7):1268-73.
doi: 10.1111/j.1532-5415.2011.03481.x. Epub 2011 Jul 7.

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

Jacques Baillargeon  1 , Yong-Fang Kuo, Yu-Li Lin, Mukaila A Raji, Amanpal Singh, James S Goodwin
Affiliations
Comparative Study

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

Jacques Baillargeon et al. J Am Geriatr Soc. 2011 Jul.

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.

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Conflict of interest statement

Conflict of Interest: The authors have no financial disclosure or any conflict of interest to report with this paper.

Comment in

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