Myocardial infarction or mental disorders after cancer diagnosis and cancer-specific survival

• Background: Receiving a cancer diagnosis has been associated with immediate risks of mental disorders and cardiovascular disease which may reflect a severe stress-response to the diagnosis. We aimed to explore the association of myocardial infarction or mental disorders shortly after a cancer diagnosis and cancer-specific survival.Methods: We conducted a prospective cohort study based on the Swedish Cancer Register including 227,943 cancer patients diagnosed during 2004-2009. Non-fetal myocardial infarction (MI) and any mental disorders during the first 90 days after cancer diagnosis were identified by record linkage to the Patient Register. We used Cox proportional hazards regression to calculate the hazard ratio (HR) and 95% confidence interval(CI) as an estimate of the association between MI or mental disorder and total cancer- and cancer-site specific survival.Results: During the first 90 days post diagnosis, 724 patients experienced MI and 2,391 were diagnosed with mental disorders. During the average of 3.2 years of follow-up, the rate of any cancer specific-death was increased among patients who experienced MI (HR:1.46, 95%CI:1.27-1.68) with the highest mortality increments observed for lung cancer (HR:1.60, 95%CI:1.21-2.12) and blood cancers (HR:1.83, 95%CI:1.18-2.84). Similarly, patients diagnosed with mental disorder had higher total cancer-specific mortality rates (HR:1.25, 95%CI:1.15-1.37) with the highest mortality increments observed for breast cancer (HR:1.56, 95%CI:1.14-2.14), lung cancer (HR:1.34, 95%CI:1.10-1.63) and blood cancer (HR:1.61, 95%CI:1.21-2.15).Conclusion: MI or mental disorder shortly after a cancer diagnosis may decrease cancer-specific survival, especially in breast-, lung-, and blood cancers (Funded by Swedish Cancer Society, Swedish Research Council for Health, Working Life and Welfare, and others).

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Psykiatri (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Psychiatry (hsv//eng)

Nyckelord

Psychiatry

Psykiatri

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