Evidence map›Paper›PMID 39318789›Full record

ArticleEClinicalMedicine2024

Early, medium and long-term mental health in cancer survivors compared with cancer-free comparators: matched cohort study using linked UK electronic health records.

Harriet Forbes, Helena Carreira, Garth Funston, Kirsty Andresen, Urvita Bhatia, Helen Strongman, Esha Abrol, Liza Bowen, Ceinwen Giles, Krishnan Bhaskaran

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in EClinicalMedicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Harriet ForbesDepartment of Non-Communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Helena CarreiraDepartment of Non-Communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Garth FunstonWolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Kirsty AndresenDepartment of Non-Communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Urvita BhatiaDepartment of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Helen StrongmanDepartment of Non-Communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Esha AbrolDivision of Psychiatry, University College London, UK.
Liza BowenPopulation Health Research Institute, St George's, University of London, London, UK.
Ceinwen GilesShine Cancer Support, Poole, Dorset, UK.
Krishnan BhaskaranDepartment of Non-Communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.

Funding

Wellcome Trust
6 · The paper itself

Abstract

Background: We aimed to compare the risk of incident depression, anxiety, non-fatal self-harm and completed suicide in survivors from a wide range of cancers versus cancer-free individuals. Methods: We used electronic health records from the United Kingdom Clinical Practice Research Datalink linked to cancer registry data, hospital admissions data and death records between 1998 and 2021. Adult survivors of the 20 most common cancers were matched (age, sex, general practice) 1:10 to cancer-free individuals. Cox regression models, adjusted for shared risk factors, were used to estimate associations between cancer survivorship and mental health outcomes. Findings: 853,177 adults with cancer diagnosed in 1998-2018 were matched to 8,106,643 cancer-free individuals. Survivors of all 20 cancer types under study had a higher risk of experiencing a new episode of anxiety and depression during follow-up compared with cancer-free individuals; there was also evidence of raised risks of non-fatal self-harm in 17/20 cancers and completed suicide in 8/20 cancers. Effect sizes were greatest in cancers with poorer 5-year survival: hazard ratios (HRs) for anxiety and depression of 1.1-1.2 were seen for malignant melanoma survivors, while HRs for both outcomes were >2.5 for lung and oesophageal cancer survivors. HRs were highest in the first year from cancer diagnosis, reducing over time since diagnosis. However, 5-year cancer survivors still experienced elevated risks of a subsequent new episode of anxiety or depression, in 18/20 cancers. Interpretation: Survivors of the 20 most common cancers were at increased risk of experiencing depression and anxiety, and these increased risks persisted in medium-to long-term cancer survivors. Substantially raised risks of non-fatal self-harm and completed suicide were also seen for several types of cancer. The risks of all mental health outcomes were generally higher in survivors of cancers with poorer prognosis. Our findings suggest a need for improved psychological support for all patients with cancer. Funding: Wellcome Trust.

Indexed as

AnxietyCancerCompleted suicideDepressionMental healthNon-fatal self-harm

Identifiers

PMID39318789
PMCPMC11421364

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.