Trine Allerslev Horsboel1, Susanne K Kjaer2, Christoffer Johansen3, Nis Palm Suppli4, Gunn Ammitzbøll5, Ligita Paskeviciute Frøding6, Henrik Lajer6, Susanne Oksbjerg Dalton7. 1. Survivorship Unit, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Nursing and Nutrition, Faculty of Health, University College Copenhagen, Denmark. Electronic address: trineah@cancer.dk. 2. Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Gynecology, Juliane Marie Center, Copenhagen University Hospital, Denmark. 3. Late Effect Research Unit CASTLE, Finsen Center, Copenhagen University Hospital, Denmark; Survivorship Unit, Danish Cancer Society Research Center, Copenhagen, Denmark. 4. Mental Health Centre Copenhagen, Copenhagen University Hospital, Denmark; Survivorship Unit, Danish Cancer Society Research Center, Copenhagen, Denmark. 5. Survivorship Unit, Danish Cancer Society Research Center, Copenhagen, Denmark. 6. Department of Gynecology, Juliane Marie Center, Copenhagen University Hospital, Denmark. 7. Survivorship Unit, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Næstved, Denmark.
Abstract
OBJECTIVE: Little is known about long-term risk of depression in women treated for gynecological cancers. We aim to investigate risk for depression among these women compared to women without a history of cancer. METHODS: We followed 16,833 women diagnosed with gynecological cancers between 1998 and 2013 and 138,888 reference women in nationwide registers for up to 19 years. Women with a history of severe psychiatric disorders, and those who had redeemed a prescription for antidepressants three years before study entry were excluded from analyses. Regression analyses were applied to compare the risk for antidepressant use among patients compared to reference women, and to investigate associations between socio-demographic as well as clinical risk factors and use of antidepressants. RESULTS: We found an increased risk for antidepressant use among women treated for ovarian (HR 4.14, 95% CI 3.74-4.59), endometrial (HR 2.19, 95% CI 1.97-2.45), and cervical cancer (HR 3.14, 95% CI 2.74-3.61) one year after diagnosis. This increased risk persisted years after diagnosis in all three groups, with the longest (up to eight years) found for ovarian cancer. Advanced disease was strongly associated with antidepressant use followed by short education, and comorbidity. CONCLUSIONS: Women diagnosed with gynecological cancer have an increased risk for depression compared to reference women. The risk remains increased for years after diagnosis throughout and beyond standard oncological follow-up care. Advanced disease, short education, and comorbidity are factors associated with antidepressant use in this patient group.
OBJECTIVE: Little is known about long-term risk of depression in women treated for gynecological cancers. We aim to investigate risk for depression among these women compared to women without a history of cancer. METHODS: We followed 16,833 women diagnosed with gynecological cancers between 1998 and 2013 and 138,888 reference women in nationwide registers for up to 19 years. Women with a history of severe psychiatric disorders, and those who had redeemed a prescription for antidepressants three years before study entry were excluded from analyses. Regression analyses were applied to compare the risk for antidepressant use among patients compared to reference women, and to investigate associations between socio-demographic as well as clinical risk factors and use of antidepressants. RESULTS: We found an increased risk for antidepressant use among women treated for ovarian (HR 4.14, 95% CI 3.74-4.59), endometrial (HR 2.19, 95% CI 1.97-2.45), and cervical cancer (HR 3.14, 95% CI 2.74-3.61) one year after diagnosis. This increased risk persisted years after diagnosis in all three groups, with the longest (up to eight years) found for ovarian cancer. Advanced disease was strongly associated with antidepressant use followed by short education, and comorbidity. CONCLUSIONS:Women diagnosed with gynecological cancer have an increased risk for depression compared to reference women. The risk remains increased for years after diagnosis throughout and beyond standard oncological follow-up care. Advanced disease, short education, and comorbidity are factors associated with antidepressant use in this patient group.
Authors: Markus W Haun; Laura Simon; Halina Sklenarova; Verena Zimmermann-Schlegel; Hans-Christoph Friederich; Mechthild Hartmann Journal: Cancer Med Date: 2021-06-02 Impact factor: 4.452