Ovarian cancer is the fifth most common female cancer in the United States. Although there have been many studies on self-reported QOL among ovarian cancer patients, there have been very few studies investigating mental disease diagnoses among ovarian cancer survivors with long term follow up. The aim of this study is to examine the incidence of mental illness among ovarian cancer survivors compared to a general population cohort. A secondary aim is to investigate risk factors for mental illnesses among ovarian cancer survivors. Cohorts of 1,689 ovarian cancer patients diagnosed between 1996 and 2012 and 7,038 women without cancer matched by age, birth state and follow up time from the general population were identified. Mental health diagnoses were identified from electronic medical records and statewide healthcare facilities data. Cox proportional hazard models were used to estimate hazard ratios (HRs). Ovarian cancer survivors experienced increased risks of mental illnesses within the first two years after cancer diagnosis (HR=3.48, 95%CI=2.98-4.05) compared to the general population. The risks of depression among ovarian cancer survivors were 3-fold within the first two years of cancer diagnosis (HR=3.11, 95%CI=2.53-3.83), and 1.67-fold at 2-5 years after cancer diagnosis (HR=1.67, 95%CI=1.17-2.38). The risk of anxiety disorder among ovarian cancer survivors was 3.54-fold at 0-2 years (HR= 3.54, 95% CI= 2.87-4.38), and 1.86-fold at 2-5 years (HR= 1.86, 95% CI= 1.14-3.01). Elevated risk for adjustment disorders was observed among ovarian cancer survivors compared with the general population cohort between 0-2 years (HR= 3.96, 95% CI= 1.00-15.84) and between 2-5 years (HR= 3.96, 95% CI= 1.00-15.84). Cancer treatment and later diagnosis year were associated with increased risk of any mental illness at 0-2 years after cancer diagnosis among ovarian cancer survivors. Distant-stage cancer was an important risk factor compared to early-stage for both mental illness and depression among ovarian cancer survivors in all time periods. Ovarian cancer patients who had a mucinous histology subtype had 47% decreased risk of any mental illness and 67% decreased risk of depression at 0-2 years, compare to those with high-grade serous histology subtype. In addition, a baseline CCI score of 1+ and older age at diagnosis (>60 years old) were important for the increased risk of depression at 0-2 years or >5 year after cancer diagnosis, respectively. Ovarian cancer survivors experienced an 80% increased risk of death with a mental illness diagnosis (HR=1.80, 95% CI=1.48-2.18) and a 94% increased risk of death with a depression diagnosis (HR=1.94, 95% CI=1.56-2.40).Higher risks of mental illnesses were observed among ovarian cancer survivors throughout the follow-up periods of 0-2 years and 2-5 years after cancer diagnosis. Multidisciplinary care is needed to monitor and treat mental illnesses among ovarian cancer survivors.
Citation Format: Siqi Hu, David Baraghoshi, Esther Chang, Kerry Rowe, John Snyder, Vikrant Deshmukh, Michael Newman, Alison Fraser, David Gaffney, Ken Smith, Kimberly Herget, Anita Peoples, Mia Hashibe. Mental health disorders among ovarian cancer survivors in a population-based cohort [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 900.