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Psychiatric disorders and cardiovascular diseases during the diagnostic workup of potential breast cancer : a population-based cohort study in Skåne, Sweden

Shen, Qing ; Jöud, Anna LU ; Schelin, Maria E C LU ; Sjölander, Arvid ; Cao, Yang ; Sparén, Pär ; Fall, Katja ; Czene, Kamila ; Valdimarsdóttir, Unnur and Fang, Fang (2019) In Breast Cancer Research 21(1). p.1-10
Abstract

BACKGROUND: An increasing number of women are evaluated for potential breast cancer and may experience mental distress during evaluation. We aim to assess the risks of psychiatric disorders and cardiovascular diseases during the diagnostic workup of potential breast cancer.

METHODS: All women with a new diagnosis of unspecified lump in breast (N = 15,714), benign tumor or breast cancer in situ (N = 4435), or breast cancer (N = 8512) during 2005-2014 in Skåne, Sweden, were considered as exposed to a breast diagnostic workup. We used multivariable Poisson regression to compare rates of psychiatric disorders and cardiovascular diseases during the 6 weeks before the date of diagnosis of these women with the corresponding rates of... (More)

BACKGROUND: An increasing number of women are evaluated for potential breast cancer and may experience mental distress during evaluation. We aim to assess the risks of psychiatric disorders and cardiovascular diseases during the diagnostic workup of potential breast cancer.

METHODS: All women with a new diagnosis of unspecified lump in breast (N = 15,714), benign tumor or breast cancer in situ (N = 4435), or breast cancer (N = 8512) during 2005-2014 in Skåne, Sweden, were considered as exposed to a breast diagnostic workup. We used multivariable Poisson regression to compare rates of psychiatric disorders and cardiovascular diseases during the 6 weeks before the date of diagnosis of these women with the corresponding rates of women not undergoing such workup. The commonest waiting time for breast cancer patients was 6 weeks during the study period. A within-individual comparison was performed to control for potential unmeasured time-stationary confounders.

RESULTS: Compared to the reference, we found a higher rate of psychiatric disorders during the 6 weeks before diagnosis of benign tumor or breast cancer in situ (incidence rate ratio [IRR], 1.3; 95% confidence interval [CI], 1.1 to 1.5) and breast cancer (IRR, 1.4; 95% CI, 1.2 to 1.6). A higher rate was also noted for cardiovascular diseases (IRR, 1.3; 95% CI, 1.1 to 1.6 for benign tumor or breast cancer in situ, and IRR, 1.9; 95% CI, 1.8 to 2.0 for breast cancer). The rate increases for breast cancer were greater comparing a diagnostic workup due to symptoms to a workup due to screening. Little rate increase of neither psychiatric disorders nor cardiovascular diseases was noted during the 6 weeks before the diagnosis of unspecified lump in breast. The within-individual comparison largely confirmed these findings.

CONCLUSIONS: Women with benign and malignant breast tumor had increased rates of psychiatric disorders and cardiovascular diseases during the waiting for a final diagnosis.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Breast Cancer Research
volume
21
issue
1
article number
139
pages
1 - 10
publisher
BioMed Central (BMC)
external identifiers
  • pmid:31823810
  • scopus:85076367822
ISSN
1465-5411
DOI
10.1186/s13058-019-1232-y
language
English
LU publication?
yes
id
98bf4116-eaf4-4884-978a-62ab3bdece17
date added to LUP
2019-12-16 12:39:41
date last changed
2021-04-27 01:02:05
@article{98bf4116-eaf4-4884-978a-62ab3bdece17,
  abstract     = {<p>BACKGROUND: An increasing number of women are evaluated for potential breast cancer and may experience mental distress during evaluation. We aim to assess the risks of psychiatric disorders and cardiovascular diseases during the diagnostic workup of potential breast cancer.</p><p>METHODS: All women with a new diagnosis of unspecified lump in breast (N = 15,714), benign tumor or breast cancer in situ (N = 4435), or breast cancer (N = 8512) during 2005-2014 in Skåne, Sweden, were considered as exposed to a breast diagnostic workup. We used multivariable Poisson regression to compare rates of psychiatric disorders and cardiovascular diseases during the 6 weeks before the date of diagnosis of these women with the corresponding rates of women not undergoing such workup. The commonest waiting time for breast cancer patients was 6 weeks during the study period. A within-individual comparison was performed to control for potential unmeasured time-stationary confounders.</p><p>RESULTS: Compared to the reference, we found a higher rate of psychiatric disorders during the 6 weeks before diagnosis of benign tumor or breast cancer in situ (incidence rate ratio [IRR], 1.3; 95% confidence interval [CI], 1.1 to 1.5) and breast cancer (IRR, 1.4; 95% CI, 1.2 to 1.6). A higher rate was also noted for cardiovascular diseases (IRR, 1.3; 95% CI, 1.1 to 1.6 for benign tumor or breast cancer in situ, and IRR, 1.9; 95% CI, 1.8 to 2.0 for breast cancer). The rate increases for breast cancer were greater comparing a diagnostic workup due to symptoms to a workup due to screening. Little rate increase of neither psychiatric disorders nor cardiovascular diseases was noted during the 6 weeks before the diagnosis of unspecified lump in breast. The within-individual comparison largely confirmed these findings.</p><p>CONCLUSIONS: Women with benign and malignant breast tumor had increased rates of psychiatric disorders and cardiovascular diseases during the waiting for a final diagnosis.</p>},
  author       = {Shen, Qing and Jöud, Anna and Schelin, Maria E C and Sjölander, Arvid and Cao, Yang and Sparén, Pär and Fall, Katja and Czene, Kamila and Valdimarsdóttir, Unnur and Fang, Fang},
  issn         = {1465-5411},
  language     = {eng},
  month        = {12},
  number       = {1},
  pages        = {1--10},
  publisher    = {BioMed Central (BMC)},
  series       = {Breast Cancer Research},
  title        = {Psychiatric disorders and cardiovascular diseases during the diagnostic workup of potential breast cancer : a population-based cohort study in Skåne, Sweden},
  url          = {http://dx.doi.org/10.1186/s13058-019-1232-y},
  doi          = {10.1186/s13058-019-1232-y},
  volume       = {21},
  year         = {2019},
}