To examine differences in survival outcomes for muscle-invasive bladder cancer patients stratified by new mental health diagnosis.
Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare data, we identified patients diagnosed with muscle-invasive bladder cancer between 2008 and 2014. Our primary outcome was cancer-specific and overall hazards of mortality. As a secondary outcome, we reported predictors of developing a new mental health diagnosis after bladder cancer diagnosis. We used Cox proportional hazards models to determine the impact of palliative care and mental health diagnoses on survival outcomes after adjusting for grade, stage, comorbidity index, and baseline demographics.
Of the 3794 patients who met inclusion criteria, 1193 (31%) were diagnosed with a mental health illness after their bladder cancer diagnosis during the 6 years in the study period. The most common diagnoses were depression (13%), alcohol and drug abuse (12%), and anxiety (11%). Patients with a post-bladder cancer mental health diagnosis had a 57% higher hazard of overall mortality (HR 1.57, P = .048) and an 80% higher hazard of bladder cancer-specific mortality (HR 1.81, P = .037) CONCLUSIONS: New mental health diagnoses are associated with worse survival in patients with muscle invasive bladder cancer. This suggests that a multimodal approach to bladder cancer treatment should include addressing the non-oncologic needs of the patient to optimize survival outcomes.
Clinical genitourinary cancer. 2022 Nov 02 [Epub ahead of print]
Omar Ayyash, Jonathan Yabes, Lee Hugar, Avinash Maganty, Stephen B Williams, Elizabeth Wulff-Burchfield, Benjamin Davies, Bruce Jacobs
Department of Urology, UPMC, Pittsburgh, PA. Electronic address: ., Center for Research on Health Care, Department of Medicine, University of Pittsburgh, Pittsburgh, PA., Department of Urology, UPMC, Pittsburgh, PA., Department of Surgery, Division of Urology, University of Texas Medical Branch, Galveston, TX., Division of Medical Oncology and Palliative Medicine, University of Kansas Medical Center, Kansas City, KS.