TABLE 4.
Risk factors for mental illness and depression among ovarian cancer survivors
| Factors | 0–2 years after cancer diagnosis | 2–5 years after cancer diagnosis | >5 years after cancer diagnosis | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mental illness | Depression | Mental illness | Depression | Mental illness | Depression | |||||||
| HR | 95% CI | HR | 95% CI | HR | 95% CI | HR | 95% CI | HR | 95% CI | HR | 95% CI | |
| Treatment a | ||||||||||||
| Surgery | Reference | Reference | Reference | Reference | Reference | Reference | ||||||
| Chemo | 1.29 | (0.81–2.05) | 0.88 | (0.45–1.72) | 0.96 | (0.38–2.43) | 1.97 | (0.78–4.98) | ||||
| Surgery + Chemo | 1.39 | (1.01–1.90) | 1.30 | (0.85–1.97) | 1.33 | (0.81–2.16) | 1.66 | (0.92–3.00) | 1.20 | (0.63–2.29) | 1.02 | (0.50–2.06) |
| No treatment | 0.84 | (0.20–3.55) | 4.82 | (0.57–40.47) | 8.09 | (0.97–67.84) | ||||||
| Cancer stage (SEER) b | ||||||||||||
| Local | Reference | Reference | Reference | Reference | Reference | Reference | ||||||
| Regional | 1.50 | (0.96–2.34) | 0.75 | (0.41–1.38) | 1.17 | (0.61–2.22) | 1.62 | (0.81–3.25 | 1.29 | (0.54–3.13) | 1.72 | (0.69–4.29) |
| Distant | 2.06 | (1.44–2.95) | 1.59 | (1.03–2.45) | 1.68 | (1.03–2.76) | 1.70 | (0.94–3.08) | 1.82 | (0.98–3.41) | 2.81 | (1.33– 5.91) |
| Diagnosis year c | ||||||||||||
| 1996–1999 | Reference | Reference | Reference | Reference | Reference | Reference | ||||||
| 2000–2003 | 1.27 | (0.90–1.79) | 0.79 | (0.45–1.39) | 1.32 | (0.75–2.32) | 1.18 | (0.60–2.32) | 0.79 | (0.41–1.54) | 1.03 | (0.49–2.17) |
| 2003–2007 | 1.26 | (0.88–1.82) | 1.62 | (0.98–2.68) | 1.35 | (0.75–2.41) | 0.82 | (0.38–1.74) | 0.46 | (0.18–1.15) | 0.58 | (0.22–1.53) |
| 2008–2012 | 1.49 | (1.06–2.09) | 1.54 | (0.94–2.51) | 1.15 | (0.65–2.05) | 1.53 | (0.81–2.89) | 0.29 | (0.04–2.31) | ||
| Histology d | ||||||||||||
| High‐grade serous | Reference | Reference | Reference | Reference | Reference | Reference | ||||||
| Low‐grade serous | 0.65 | (0.21–2.07) | 0.75 | (0.18–3.14) | 1.85 | (0.55–6.22) | 4.95 | (1.50–16.36) | 1.58 | (0.30–8.34) | ||
| Endometrioid | 0.72 | (0.46–1.12) | 0.564 | (0.31–1.04) | 0.49 | (0.23–1.03) | 0.40 | (0.16–1.01) | 1.05 | (0.46–2.39) | 0.67 | (0.28–1.61) |
| Mucinous | 0.53 | (0.30–0.95) | 0.33 | (0.13–0.82) | 0.82 | (0.38–1.76) | 1.09 | (0.50–2.41) | 1.11 | (0.48–2.54) | 0.80 | (0.29–2.16) |
| Clear cell | 0.75 | (0.44–1.28) | 0.55 | (0.26–1.19) | 0.94 | (0.42–2.09) | 1.20 | (0.50–2.88) | 0.28 | (0.03–2.24) | 0.30 | (0.04–2.29) |
| Carcinosarcoma | 1.40 | (0.65–3.00) | 1.11 | (0.41–3.05) | 0.79 | (0.11–5.81) | ||||||
| Carcinoma, NOS | 1.34 | (0.96–1.86) | 1.06 | (0.65–1.73) | 0.68 | (0.29–1.61) | 0.80 | (0.28–2.26) | 1.64 | (0.51–5.22) | 0.23 | (0.03–1.74) |
| Other h | 0.60 | (0.37–0.97) | 0.57 | (0.30–1.06) | 1.00 | (0.51–1.95) | 0.98 | (0.44–2.18) | 0.62 | (0.17–2.27) | 0.62 | (0.20–1.95) |
| Baseline CCI e | ||||||||||||
| 0 | Reference | Reference | Reference | Reference | Reference | Reference | ||||||
| 1+ | 1.28 | (0.99–1.66) | 1.54 | (1.10–2.14) | 1.51 | (0.98–2.33) | 1.38 | (0.83–2.27) | 1.22 | (0.59–2.53) | 1.32 | (0.62–2.80) |
| Baseline BMI (kg/m2) f | ||||||||||||
| <18.5 | 1.09 | (0.53–2.23) | 1.30 | (0.53–3.24) | 0.87 | (0.21–3.65) | 2.13 | (0.64–7.05) | 1.02 | (0.14–7.68) | 2.69 | (0.61–11.85) |
| 18.5–24.9 | Reference | Reference | Reference | Reference | Reference | Reference | ||||||
| 25–29.9 | 1.03 | (0.79–1.35) | 1.191 | (0.83–1.72) | 1.12 | (0.70–1.78) | 1.32 | (0.76–2.29) | 0.67 | (0.34–1.32) | 0.97 | (0.48–1.94) |
| >30 | 0.91 | (0.67–1.24) | 1.15 | (0.77–1.74) | 1.11 | (0.66–1.85) | 1.28 | (0.71–2.33) | 1.21 | (0.60–2.43) | 0.54 | (0.20–1.45) |
| Age at diagnosis (y) g | ||||||||||||
| <60 | Reference | Reference | Reference | Reference | Reference | Reference | ||||||
| ≥ 60 | 0.89 | (0.71–1.13) | 0.75 | (0.54–1.02) | 1.25 | (0.83–1.88) | 1.16 | (0.73–1.85) | 2.31 | (1.31– 4.08) | 1.89 | (1.01– 3.54) |
Note: Bold value indicates statistical significance (p < 0.05).
Abbreviations: BMI, body mass index; CCI, Charlson Comorbidity Index; CI, confidence interval; HR, hazard ratio.
Adjusted for race/ethnicity, baseline BMI, baseline CCI, cancer stage, age at diagnosis, income and education.
Adjusted for race/ethnicity, baseline BMI, diagnosis year, age at diagnosis, income and education.
Adjusted for baseline BMI and baseline CCI.
Adjusted for race/ethnicity, baseline BMI, age at diagnosis, diagnosis year, income and education.
Adjusted for race/ethnicity and age at diagnosis.
Adjusted for race/ethnicity, diagnosis age, income and education.
Adjusted for race/ethnicity and cancer stage.
Including Malignant Brenner, Mixed, Non‐specific.