Racial differences in the incidence of mental health illness among ovarian cancer patients: An analysis of SEER-Medicare data

Background: Ovarian cancer (OC) patients have an increased risk for a mental health illness (MHI) after their cancer diagnosis, but limited research exists on whether this risk differs by race/ethnicity. Hence, we used SEER-Medicare data to evaluate racial/ethnic differences in MHI incidence among O...

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Main Authors: Fariha Rahman, Oyomoare L. Osazuwa-Peters, Clare Meernik, Kevin C. Ward, Margaret G. Kuliszewski, Bin Huang, Andrew Berchuck, Thomas Tucker, Maria Pisu, Margaret Liang, Tomi F. Akinyemiju
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:SSM - Mental Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666560324000288
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author Fariha Rahman
Oyomoare L. Osazuwa-Peters
Clare Meernik
Kevin C. Ward
Margaret G. Kuliszewski
Bin Huang
Andrew Berchuck
Thomas Tucker
Maria Pisu
Margaret Liang
Tomi F. Akinyemiju
author_facet Fariha Rahman
Oyomoare L. Osazuwa-Peters
Clare Meernik
Kevin C. Ward
Margaret G. Kuliszewski
Bin Huang
Andrew Berchuck
Thomas Tucker
Maria Pisu
Margaret Liang
Tomi F. Akinyemiju
author_sort Fariha Rahman
collection DOAJ
description Background: Ovarian cancer (OC) patients have an increased risk for a mental health illness (MHI) after their cancer diagnosis, but limited research exists on whether this risk differs by race/ethnicity. Hence, we used SEER-Medicare data to evaluate racial/ethnic differences in MHI incidence among OC patients aged 65+. Methods: Non-Hispanic (NH) Black, NH White, and Hispanic women diagnosed with OC in 2008–2015 without a mental health history 12 months prior to their cancer diagnosis were identified from SEER-Medicare. Cox proportional hazards regression evaluated new MHI incidence in the first five years post diagnosis and the differences by race/ethnicity. Hazard ratios (HR) and 95% confidence intervals (CI) adjusted for demographic/clinical covariates and healthcare access (HCA) dimensions. Results: We identified 5441 OC patients, including 364 NH Black (6.7%), 4982 NH White (91.6%), and 95 Hispanic (1.7%) patients. About 41% of NH White, 33.3% of NH Black, and 37.2% of Hispanic OC patients were diagnosed with MHI during the follow-up period between 2008 and 2016. In the fully adjusted model, NH Black OC patients were less likely to be diagnosed with any MHI (aHR: 0.67, 95% CI: 0.54, 0.82), depression (aHR: 0.66, 95% CI: 0.51, 0.86), and anxiety disorder (aHR: 0.64, 95% CI: 0.49, 0.84), while Hispanic OC patients were less likely to be diagnosed with anxiety disorder (aHR: 0.56, 95% CI: 0.33, 0.95) compared to NH White OC patients. Discussion: NH Black OC patients are less likely to receive a clinical MHI diagnosis compared to NH White OC patients. Further studies on racial differences in MHI incidence after OC diagnosis in primary cohorts are needed to better estimate population-level prevalence less vulnerable to exposure misclassification and to account for patient-level factors impacting MHI.
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spelling doaj-art-1801ebc648fd4e649394e1d804cdf9f42025-08-20T02:38:13ZengElsevierSSM - Mental Health2666-56032024-12-01610032310.1016/j.ssmmh.2024.100323Racial differences in the incidence of mental health illness among ovarian cancer patients: An analysis of SEER-Medicare dataFariha Rahman0Oyomoare L. Osazuwa-Peters1Clare Meernik2Kevin C. Ward3Margaret G. Kuliszewski4Bin Huang5Andrew Berchuck6Thomas Tucker7Maria Pisu8Margaret Liang9Tomi F. Akinyemiju10Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USADepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC, USADepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC, USAGeorgia Cancer Registry, Emory University, Atlanta, GA, USANew York State Cancer Registry, New York State Department of Health, Albany, NY, USADivision of Cancer Biostatistics and Kentucky Cancer Registry, University of Kentucky, Lexington, KY, USADuke Division of Gynecologic Oncology, Durham, NC, USADepartment of Epidemiology and Environmental Health and Kentucky Cancer Registry, University of Kentucky, Lexington, KY, USADivision of Preventive Medicine and O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USADivison of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USADepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA; Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA; Corresponding author. Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.Background: Ovarian cancer (OC) patients have an increased risk for a mental health illness (MHI) after their cancer diagnosis, but limited research exists on whether this risk differs by race/ethnicity. Hence, we used SEER-Medicare data to evaluate racial/ethnic differences in MHI incidence among OC patients aged 65+. Methods: Non-Hispanic (NH) Black, NH White, and Hispanic women diagnosed with OC in 2008–2015 without a mental health history 12 months prior to their cancer diagnosis were identified from SEER-Medicare. Cox proportional hazards regression evaluated new MHI incidence in the first five years post diagnosis and the differences by race/ethnicity. Hazard ratios (HR) and 95% confidence intervals (CI) adjusted for demographic/clinical covariates and healthcare access (HCA) dimensions. Results: We identified 5441 OC patients, including 364 NH Black (6.7%), 4982 NH White (91.6%), and 95 Hispanic (1.7%) patients. About 41% of NH White, 33.3% of NH Black, and 37.2% of Hispanic OC patients were diagnosed with MHI during the follow-up period between 2008 and 2016. In the fully adjusted model, NH Black OC patients were less likely to be diagnosed with any MHI (aHR: 0.67, 95% CI: 0.54, 0.82), depression (aHR: 0.66, 95% CI: 0.51, 0.86), and anxiety disorder (aHR: 0.64, 95% CI: 0.49, 0.84), while Hispanic OC patients were less likely to be diagnosed with anxiety disorder (aHR: 0.56, 95% CI: 0.33, 0.95) compared to NH White OC patients. Discussion: NH Black OC patients are less likely to receive a clinical MHI diagnosis compared to NH White OC patients. Further studies on racial differences in MHI incidence after OC diagnosis in primary cohorts are needed to better estimate population-level prevalence less vulnerable to exposure misclassification and to account for patient-level factors impacting MHI.http://www.sciencedirect.com/science/article/pii/S2666560324000288Ovarian cancerHealthcare accessRacial disparitiesMental healthMental health diagnosis
spellingShingle Fariha Rahman
Oyomoare L. Osazuwa-Peters
Clare Meernik
Kevin C. Ward
Margaret G. Kuliszewski
Bin Huang
Andrew Berchuck
Thomas Tucker
Maria Pisu
Margaret Liang
Tomi F. Akinyemiju
Racial differences in the incidence of mental health illness among ovarian cancer patients: An analysis of SEER-Medicare data
SSM - Mental Health
Ovarian cancer
Healthcare access
Racial disparities
Mental health
Mental health diagnosis
title Racial differences in the incidence of mental health illness among ovarian cancer patients: An analysis of SEER-Medicare data
title_full Racial differences in the incidence of mental health illness among ovarian cancer patients: An analysis of SEER-Medicare data
title_fullStr Racial differences in the incidence of mental health illness among ovarian cancer patients: An analysis of SEER-Medicare data
title_full_unstemmed Racial differences in the incidence of mental health illness among ovarian cancer patients: An analysis of SEER-Medicare data
title_short Racial differences in the incidence of mental health illness among ovarian cancer patients: An analysis of SEER-Medicare data
title_sort racial differences in the incidence of mental health illness among ovarian cancer patients an analysis of seer medicare data
topic Ovarian cancer
Healthcare access
Racial disparities
Mental health
Mental health diagnosis
url http://www.sciencedirect.com/science/article/pii/S2666560324000288
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