Predictive Value of Individual Behavioral Risk Factors for New Mood-Related Psychiatric Disorder After Diagnosis of Cancer

Abstract

Objective: The diagnosis of a mood-related psychiatric disorder (MRPD) among patients with cancer has been associated with decreased quality of life and lower cancer survival. This study aimed to understand the risk of a new MRPD after cancer diagnosis by individual risk behaviors, with a specific focus on tobacco use and the presence of a human papillomavirus (HPV)-associated cancer. Methods: Single-center retrospective cohort study of 11,712 patients diagnosed with cancer between 2009 and 2020. We identified predictors of a new MRPD after cancer diagnosis using a time-to-event analysis and Cox proportional hazards model including demographics, disease characteristics, and tobacco use and HPV-associated tumors. Results: Univariate analyses revealed lower hazard ratios (HRs) of a new MRPD among individuals that identified as Asian/Pacific Islanders and among the older age groups (> 51 years). Univariate analyses additionally demonstrated higher HRs of MRPD among females; sexual minorities; former and current smokers; individuals with HPV-associated cancers; and individuals diagnosed at later stages. These relationships were observed in the multivariate model when adjusting for covariates. Shorter time-to-MRPD was observed when stratifying by individual behavioral risk factors, with active smokers and individuals with an HPV-associated cancer being at the highest risk. Conclusions: Individual behavioral risk factors increase risk of new MRPD after being diagnosed with cancer. These findings build on past studies by linking tobacco use and HPV-associated cancers with MRPD risk in oncology and can be used to identify patients at risk of developing new MRPDs post-cancer diagnosis and engaging them in treatment.