Colon cancer patients with a serious psychiatric disorder present with a more advanced cancer stage and receive less adjuvant chemotherapy - A Nationwide Danish Cohort Study

Linda Kaerlev, Maria Iachina, Oleg Trosko, Niels Qvist, Pernille Møller Ljungdalh, Bente Mertz Nørgård

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Resumé

BACKGROUND: Psychiatric patients with colorectal cancer may have delayed diagnosis and be oncologically undertreated.

METHODS: The Danish Colorectal Cancer Group database comprised 25,194 colorectal cancer patients (CRC), (colon cancer (CC, n = 16,641), rectal cancer (RC, n = 8553)), having an operation in 2007-2013, were alive at least 30 days after operation, of which 422 have had at least one hospital contact for a serious psychiatric disorder; ICD-10: DF20-29: primary psychotic disorders, or DF30-39: affective disorders (exposed) in a period of 3650-120 days before the operation date. Pearson chi-squared test for cancer stage was calculated. Odds Ratio (OR) with 95% confidence interval (CI) for having had a palliative vs an intended curative aim of the operative treatment for CRC patients (cohort 1), and for having an oncological treatment for each cancer site CC or RC (cohort 2 and 3) in patients with and without a psychiatric history was estimated. We adjusted the OR for: age, gender, comorbidity index, cancer stage, socio-economic position group, and educational level.

RESULTS: A higher cancer stage at the time of operation in patients with psychiatric disorders compared with patients without such a history was seen and may possibly point towards a delay in the diagnosis or in the treatment of CC in patients with psychiatric disorders. They also had decreased adjusted OR for having an oncological treatment, OR 0.55, 95% CI (0.40-0.76)), which was not explained by cancer stage. For patients with RC no difference was seen.

CONCLUSIONS: Attention for CC patients with pre-existing serious psychiatric disorders is recommended.

OriginalsprogEngelsk
Artikelnummer1050
TidsskriftBMC Cancer
Vol/bind18
Antal sider10
ISSN1471-2407
DOI
StatusUdgivet - 29. okt. 2018

Fingeraftryk

Adjuvant Chemotherapy
Colonic Neoplasms
Cohort Studies
Neoplasms
Colorectal Neoplasms
Odds Ratio
Confidence Intervals
Delayed Diagnosis
International Classification of Diseases
Rectal Neoplasms
Comorbidity
History
Databases

Citer dette

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title = "Colon cancer patients with a serious psychiatric disorder present with a more advanced cancer stage and receive less adjuvant chemotherapy - A Nationwide Danish Cohort Study",
abstract = "BACKGROUND: Psychiatric patients with colorectal cancer may have delayed diagnosis and be oncologically undertreated.METHODS: The Danish Colorectal Cancer Group database comprised 25,194 colorectal cancer patients (CRC), (colon cancer (CC, n = 16,641), rectal cancer (RC, n = 8553)), having an operation in 2007-2013, were alive at least 30 days after operation, of which 422 have had at least one hospital contact for a serious psychiatric disorder; ICD-10: DF20-29: primary psychotic disorders, or DF30-39: affective disorders (exposed) in a period of 3650-120 days before the operation date. Pearson chi-squared test for cancer stage was calculated. Odds Ratio (OR) with 95{\%} confidence interval (CI) for having had a palliative vs an intended curative aim of the operative treatment for CRC patients (cohort 1), and for having an oncological treatment for each cancer site CC or RC (cohort 2 and 3) in patients with and without a psychiatric history was estimated. We adjusted the OR for: age, gender, comorbidity index, cancer stage, socio-economic position group, and educational level.RESULTS: A higher cancer stage at the time of operation in patients with psychiatric disorders compared with patients without such a history was seen and may possibly point towards a delay in the diagnosis or in the treatment of CC in patients with psychiatric disorders. They also had decreased adjusted OR for having an oncological treatment, OR 0.55, 95{\%} CI (0.40-0.76)), which was not explained by cancer stage. For patients with RC no difference was seen.CONCLUSIONS: Attention for CC patients with pre-existing serious psychiatric disorders is recommended.",
keywords = "Colon and rectal cancer, Mood disorders, Oncological treatment, Operation, Psychiatric disorders, Psychotic disorders",
author = "Linda Kaerlev and Maria Iachina and Oleg Trosko and Niels Qvist and Ljungdalh, {Pernille M{\o}ller} and N{\o}rg{\aa}rd, {Bente Mertz}",
year = "2018",
month = "10",
day = "29",
doi = "10.1186/s12885-018-4879-3",
language = "English",
volume = "18",
journal = "B M C Cancer",
issn = "1471-2407",
publisher = "BioMed Central",

}

TY - JOUR

T1 - Colon cancer patients with a serious psychiatric disorder present with a more advanced cancer stage and receive less adjuvant chemotherapy - A Nationwide Danish Cohort Study

AU - Kaerlev, Linda

AU - Iachina, Maria

AU - Trosko, Oleg

AU - Qvist, Niels

AU - Ljungdalh, Pernille Møller

AU - Nørgård, Bente Mertz

PY - 2018/10/29

Y1 - 2018/10/29

N2 - BACKGROUND: Psychiatric patients with colorectal cancer may have delayed diagnosis and be oncologically undertreated.METHODS: The Danish Colorectal Cancer Group database comprised 25,194 colorectal cancer patients (CRC), (colon cancer (CC, n = 16,641), rectal cancer (RC, n = 8553)), having an operation in 2007-2013, were alive at least 30 days after operation, of which 422 have had at least one hospital contact for a serious psychiatric disorder; ICD-10: DF20-29: primary psychotic disorders, or DF30-39: affective disorders (exposed) in a period of 3650-120 days before the operation date. Pearson chi-squared test for cancer stage was calculated. Odds Ratio (OR) with 95% confidence interval (CI) for having had a palliative vs an intended curative aim of the operative treatment for CRC patients (cohort 1), and for having an oncological treatment for each cancer site CC or RC (cohort 2 and 3) in patients with and without a psychiatric history was estimated. We adjusted the OR for: age, gender, comorbidity index, cancer stage, socio-economic position group, and educational level.RESULTS: A higher cancer stage at the time of operation in patients with psychiatric disorders compared with patients without such a history was seen and may possibly point towards a delay in the diagnosis or in the treatment of CC in patients with psychiatric disorders. They also had decreased adjusted OR for having an oncological treatment, OR 0.55, 95% CI (0.40-0.76)), which was not explained by cancer stage. For patients with RC no difference was seen.CONCLUSIONS: Attention for CC patients with pre-existing serious psychiatric disorders is recommended.

AB - BACKGROUND: Psychiatric patients with colorectal cancer may have delayed diagnosis and be oncologically undertreated.METHODS: The Danish Colorectal Cancer Group database comprised 25,194 colorectal cancer patients (CRC), (colon cancer (CC, n = 16,641), rectal cancer (RC, n = 8553)), having an operation in 2007-2013, were alive at least 30 days after operation, of which 422 have had at least one hospital contact for a serious psychiatric disorder; ICD-10: DF20-29: primary psychotic disorders, or DF30-39: affective disorders (exposed) in a period of 3650-120 days before the operation date. Pearson chi-squared test for cancer stage was calculated. Odds Ratio (OR) with 95% confidence interval (CI) for having had a palliative vs an intended curative aim of the operative treatment for CRC patients (cohort 1), and for having an oncological treatment for each cancer site CC or RC (cohort 2 and 3) in patients with and without a psychiatric history was estimated. We adjusted the OR for: age, gender, comorbidity index, cancer stage, socio-economic position group, and educational level.RESULTS: A higher cancer stage at the time of operation in patients with psychiatric disorders compared with patients without such a history was seen and may possibly point towards a delay in the diagnosis or in the treatment of CC in patients with psychiatric disorders. They also had decreased adjusted OR for having an oncological treatment, OR 0.55, 95% CI (0.40-0.76)), which was not explained by cancer stage. For patients with RC no difference was seen.CONCLUSIONS: Attention for CC patients with pre-existing serious psychiatric disorders is recommended.

KW - Colon and rectal cancer

KW - Mood disorders

KW - Oncological treatment

KW - Operation

KW - Psychiatric disorders

KW - Psychotic disorders

U2 - 10.1186/s12885-018-4879-3

DO - 10.1186/s12885-018-4879-3

M3 - Journal article

VL - 18

JO - B M C Cancer

JF - B M C Cancer

SN - 1471-2407

M1 - 1050

ER -