TY - JOUR

T1 - Increased risk for depression persists for years among women treated for gynecological cancers - a register-based cohort study with up to 19 years of follow-up

AU - Horsboel, Trine Allerslev

AU - Kjaer, Susanne K

AU - Johansen, Christoffer

AU - Suppli, Nis Palm

AU - Ammitzbøll, Gunn

AU - Frøding, Ligita Paskeviciute

AU - Lajer, Henrik

AU - Dalton, Susanne Oksbjerg

N1 - Copyright © 2019 Elsevier Inc. All rights reserved.

PY - 2019/6

Y1 - 2019/6

N2 - OBJECTIVE: Little is known about long-term risk of depression in women treated for gynecological cancers. We aim to investigate risk for depression among these women compared to women without a history of cancer.METHODS: We followed 16,833 women diagnosed with gynecological cancers between 1998 and 2013 and 138,888 reference women in nationwide registers for up to 19 years. Women with a history of severe psychiatric disorders, and those who had redeemed a prescription for antidepressants three years before study entry were excluded from analyses. Regression analyses were applied to compare the risk for antidepressant use among patients compared to reference women, and to investigate associations between socio-demographic as well as clinical risk factors and use of antidepressants.RESULTS: We found an increased risk for antidepressant use among women treated for ovarian (HR 4.14, 95% CI 3.74-4.59), endometrial (HR 2.19, 95% CI 1.97-2.45), and cervical cancer (HR 3.14, 95% CI 2.74-3.61) one year after diagnosis. This increased risk persisted years after diagnosis in all three groups, with the longest (up to eight years) found for ovarian cancer. Advanced disease was strongly associated with antidepressant use followed by short education, and comorbidity.CONCLUSIONS: Women diagnosed with gynecological cancer have an increased risk for depression compared to reference women. The risk remains increased for years after diagnosis throughout and beyond standard oncological follow-up care. Advanced disease, short education, and comorbidity are factors associated with antidepressant use in this patient group.

AB - OBJECTIVE: Little is known about long-term risk of depression in women treated for gynecological cancers. We aim to investigate risk for depression among these women compared to women without a history of cancer.METHODS: We followed 16,833 women diagnosed with gynecological cancers between 1998 and 2013 and 138,888 reference women in nationwide registers for up to 19 years. Women with a history of severe psychiatric disorders, and those who had redeemed a prescription for antidepressants three years before study entry were excluded from analyses. Regression analyses were applied to compare the risk for antidepressant use among patients compared to reference women, and to investigate associations between socio-demographic as well as clinical risk factors and use of antidepressants.RESULTS: We found an increased risk for antidepressant use among women treated for ovarian (HR 4.14, 95% CI 3.74-4.59), endometrial (HR 2.19, 95% CI 1.97-2.45), and cervical cancer (HR 3.14, 95% CI 2.74-3.61) one year after diagnosis. This increased risk persisted years after diagnosis in all three groups, with the longest (up to eight years) found for ovarian cancer. Advanced disease was strongly associated with antidepressant use followed by short education, and comorbidity.CONCLUSIONS: Women diagnosed with gynecological cancer have an increased risk for depression compared to reference women. The risk remains increased for years after diagnosis throughout and beyond standard oncological follow-up care. Advanced disease, short education, and comorbidity are factors associated with antidepressant use in this patient group.

KW - Adult

KW - Aged

KW - Antidepressive Agents/therapeutic use

KW - Case-Control Studies

KW - Comorbidity

KW - Denmark/epidemiology

KW - Depression/drug therapy

KW - Educational Status

KW - Endometrial Neoplasms/psychology

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Middle Aged

KW - Ovarian Neoplasms/psychology

KW - Registries

KW - Risk Assessment

KW - Time Factors

KW - Uterine Cervical Neoplasms/psychology

U2 - 10.1016/j.ygyno.2019.03.259

DO - 10.1016/j.ygyno.2019.03.259

M3 - Journal article

C2 - 30975472

VL - 153

SP - 625

EP - 632

JO - Gynecologic Oncology

JF - Gynecologic Oncology

SN - 0090-8258

IS - 3

ER -