Depression and survival in head and neck cancer patients

•Nearly 19% of HNC patients had a depression diagnosis during the study period.•Pre-cancer depression was associated with 1.49 times greater hazard of cancer-specific mortality.•Post-cancer depression was associated with 1.38 times greater hazard of cancer-specific mortality.•Pre-cancer depression was associated with 1.55 times greater hazard of all-cause mortality.•Post-cancer depression was associated with 1.40 times greater hazard of all-cause mortality.

ObjectiveThough depression often afflicts head and neck cancer (HNC) patients, few studies have examined the association between depression and survival in this particular cancer population. The objective of this study is to investigate the five-year survival of HNC patients by depression status.Materials and methodsThis study used SEER-Medicare data from 2002-2010 and identified depression diagnosis two years before and one year after cancer diagnosis. HNC patients were identified using ICD-O3 codes and depression was identified using ICD-9-CM codes from Medicare claims.ResultsOf the 3466 patients included in the study, 642 (18.5%) were diagnosed with depression during the study period. Compared to those who received no depression diagnosis, those diagnosed with depression prior to cancer or after cancer diagnosis were more likely to die of cancer (HR = 1.49; 95% CI = 1.27, 1.76 and HR = 1.38; 95% CI = 1.16, 1.65, respectively). Similarly, when looking at death from any cause, those diagnosed with depression prior to cancer diagnosis and those who received a diagnosis of depression after cancer were more likely to die from any death compared to those without depression (HR = 1.55; 95% CI = 1.36, 1.76 and HR = 1.40; 95% CI = 1.21, 1.62, respectively).ConclusionsThe results emphasize the need for early identification and treatment of depression in HNC patients, as well as the establishment of policies to routinely screen these patients throughout the cancer treatment process.