The impact of mental health disorders on healthcare utilization in cancer survivors.

529 Background: Studies have shown that cancer survivors have higher rates of functional limitation, pain, fatigue, and sadness compared to those without cancer. We endeavored to describe a cohort of patients with non-metastatic solid tumor malignancies, examine the differences between patients who have hospitalizations within five years of their cancer diagnosis, and uncover the effect of medical and mental health comorbidities on emergency department (ED) visits and hospital admissions. Methods: A retrospective study was performed using TriNetX. Patients with newly diagnosed with non-metastatic solid tumors at the Medical College of Wisconsin from January 1, 2013 to January 1, 2024 were identified. Using the TriNetX web portal and analytic platform, appropriate patient cohorts were selected, propensity score matching was performed, and psychologic and healthcare utilization outcomes were analyzed. Results: A total of 4,920 patients with non-metastatic breast (n=1520), prostate (n=1930), lung (n=440), colorectal (n=460), pancreas (n=300), and bladder (n=270) cancer were identified. Within one year of cancer diagnosis, 19.1% of patients developed a new anxiety or depressive disorder, 14.8% had at least one ED visit, and 17.5% had at least one hospital admission. Pre-existing mood or anxiety disorders, or developing new mood or anxiety disorders within the first year of cancer diagnosis was found to be associated with higher likelihood of ED visits, and associated with higher likelihood of hospital admission for patients with breast, lung, and bladder cancer. Compared to non-cancer controls, cancer survivors had a higher likelihood of developing a new mood or anxiety disorder (OR 2.2), ED visit (OR 2.1), and hospital admission (OR 3.4). Conclusions: Patients diagnosed with non-metastatic solid tumor malignancies are at higher risk of developing new mood or anxiety disorders, which is associated with higher risk of ED visits and hospitalization. Further studies to evaluate interventions in this patient cohort are needed. Likelihood of ED visits and hospital admissions of cancer survivors within 5 years of diagnosis, stratified by the presence of mental health disorder. ED Visits Hospital Admission Cancer MH Diagnosis N Matched N ED Odds Ratio (95% CI) Admitted Odds Ratio (95% CI) Breast Yes 750 540 46.3% 2.463(1.906, 3.182) 31.5% 1.608(1.225, 2.111) No 780 540 25.9% 22.2% Prostate Yes 310 300 50.0% 2(1.438, 2.782) 43.3% 1.321(0.952, 1.833) No 1620 300 33.3% 36.7% Lung Yes 140 120 58.3% 2.8(1.656, 4.734) 66.7% 2(1.187, 3.37) No 300 120 33.3% 50.0% Colorectal Yes 120 110 63.6% 3.063(1.768, 5.305) 63.6% 1.458(0.85, 2.503) No 350 110 36.4% 54.5% Pancreas Yes 80 60 33.3% 2.5(1.052, 5.941) 66.7% 1(0.468, 2.136) No 220 60 16.7% 66.7% Bladder Yes 50 50 60.0% 2.25(1.011, 5.008) 80.0% 2.667(1.09, 6.524) No 220 50 40.0% 60.0% All Cancers Yes 640 550 47.3% 2.185(1.704, 2.803) 36.4% 1.175(0.916, 1.506) No 4130 550 29.1% 32.7%