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Presence of psychiatric disorders is associated with poorer colon cancer outcomes in older adults

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Question

Question

To what extent do pre-existing mental disorders affect the diagnosis, treatment and survival in older adults with colon cancer?

Population

80 670 Medicare recipients aged 67 and older who were diagnosed with colon cancer between 1993 and 2005 (including diagnoses made at autopsy). The study population was identified using Surveillance, Epidemiology and End Results (SEER) – Medicare linked data.

Setting

Medicare recipients, USA; 1993 to 2005.

Prognostic factors

Diagnoses of psychiatric disorders during the 2-year period before cancer diagnosis, as recorded in the Medicare claims data files. The disorders included were all mood disorders, all psychotic disorders, dementia, substance abuse and dependence disorders and any other mental disorders that did not fall into those categories. Diagnoses were identified by the presence of International Classification of Diseases, Ninth Revision, Clinical Modification codes corresponding to the diagnoses listed, recorded at any visit and in any position from inpatient, hospital outpatient and from physician claims. Data on sociodemographic characteristics was also collected. Survival analyses were controlled for age, ethnicity, comorbidity, cancer stage (American Joint Committee on Cancer stage) and SEER site where …

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