A new study has found that women suffering from depression may have reduced chances of surviving breast cancer, indicating the crucial need for identifying and treating depression for patient well-being.
The research, published in the peer-reviewed journal of the American Cancer Society, CANCER, revealed that depression before or after a breast cancer diagnosis was linked to lower survival rates.
To conduct the study, Bin Huang, DrPH, and a team of researchers from the University of Kentucky Markey Cancer Center analyzed data from the Kentucky Cancer Registry. The data included adult women who were diagnosed with primary invasive breast cancer between 2007 and 2011.
The team utilized health claims-linked cancer registry data to categorize patients into four groups based on their depression diagnosis: no depression, depression diagnosis only before cancer diagnosis, depression diagnosis only after cancer diagnosis, or persistent depression.
In addition, the team assessed whether patients received guideline-recommended treatment as per the National Comprehensive Cancer Network breast cancer treatment guidelines. The study included 6,054 patients, among whom 4.1%, 3.7%, and 6.2% had persistent depression, depression pre-diagnosis only, and depression post-diagnosis only, respectively.
The team’s analysis revealed that 29.2% of patients did not receive guideline-recommended breast cancer treatment, and during a median follow-up of 4 years, 26.3% of patients died.
The study found that patients with post-diagnosis or persistent depression had a comparable likelihood of receiving guideline-recommended treatment to those with no depression.
However, patients with depression pre-diagnosis had 25% lower odds of receiving guideline-concordant care, although the significance of this finding was marginally low. Further research is required to identify potential reasons for this association.
Depression pre-diagnosis and post-diagnosis (excluding persistent depression) were linked to a higher risk of death compared to no depression. Specifically, depression pre-diagnosis was associated with a 26% increase in the risk of death, and depression post-diagnosis was associated with a 50% higher risk.
Patients who did not receive guideline-recommended treatment had a 118% higher risk of death than those who received recommended care.
Although no significant differences in survival were found, the study discovered that patients residing in Appalachia were 18% less likely to receive recommended care than patients living in non-Appalachian Kentucky. The results highlight the critical role of diagnosing and treating depression for patient care and survival, particularly at the time of breast cancer diagnosis and beyond.
“A surprising result from this study is that patients with persistent depression did not experience worse survival compared with patients with no depression,” comments Dr. Huang. “Given that under-diagnosis and under-treatment of depression are common among cancer patients, persistent depression could be an indication that patients’ depression may have been well managed. Hence, this particular result suggests the importance of depression screening and management throughout a cancer patient’s care.”
Dr. Huang emphasized that using population-based cancer registry data improves population-based cancer outcomes research. He stated that utilizing linked health claims data and cancer registry data in this study demonstrated the importance of linking data across various sources to identify potential health disparities and pinpoint areas where improvements in cancer care are needed.
He also highlighted the need for more comprehensive studies in depression management across various cancer sites and patient populations.
Source: 10.1002/cncr.34676
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