PMID- 26063243
OWN - NLM
STAT- MEDLINE
DCOM- 20160606
LR  - 20181113
IS  - 2045-7634 (Electronic)
IS  - 2045-7634 (Print)
IS  - 2045-7634 (Linking)
VI  - 4
IP  - 9
DP  - 2015 Sep
TI  - The effect of pre-existing mental health comorbidities on the stage at diagnosis 
      and timeliness of care of solid tumor malignances in a Veterans Affairs (VA) 
      medical center.
PG  - 1365-73
LID - 10.1002/cam4.483 [doi]
AB  - There are limited data on the impact of mental health comorbidities (MHC) on 
      stage at diagnosis and timeliness of cancer care. Axis I MHC affect approximately 
      30% of Veterans receiving care within the Veterans Affairs (VA) system. The 
      purpose of this study was to compare stage at diagnosis and timeliness of care of 
      solid tumor malignancies among Veterans with and without MHC. We performed a 
      retrospective analysis of 408 charts of Veterans with colorectal, urothelial, and 
      head/neck cancer diagnosed and treated at VA Connecticut Health Care System 
      (VACHS) between 2008 and 2011. We collected demographic data, stage at diagnosis, 
      medical and mental health co-morbidities, treatments received, key time 
      intervals, and number of appointments missed. The study was powered to assess for 
      stage migration of 15-20% from Stage I/II to Stage III/IV. There was no 
      significant change in stage distribution for patients with and without MHC in the 
      entire study group (p = 0.9442) and in each individual tumor type. There were no 
      significant differences in the time intervals from onset of symptoms to 
      initiation of treatment between patients with and without MHC (p = 0.1135, 0.2042 
      and 0.2352, respectively). We conclude that at VACHS, stage at diagnosis for 
      patients with colorectal, urothelial and head and neck cancers did not differ 
      significantly between patients with and without MHC. Patients with MHC did not 
      experience significant delays in care. Our study indicates that in a medical 
      system in which mental health is integrated into routine care, patients with Axis 
      I MHC do not experience delays in cancer care.
CI  - (c) 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
FAU - Wadia, Roxanne J
AU  - Wadia RJ
AD  - Yale School of Medicine, Yale University, New Haven, Connecticut.
AD  - Veterans Affairs Healthcare System, West Haven, Connecticut.
FAU - Yao, Xiaopan
AU  - Yao X
AD  - Yale School of Public Health, Yale University, New Haven, Connecticut.
FAU - Deng, Yanhong
AU  - Deng Y
AD  - Yale School of Public Health, Yale University, New Haven, Connecticut.
FAU - Li, Jia
AU  - Li J
AD  - Yale School of Medicine, Yale University, New Haven, Connecticut.
AD  - Veterans Affairs Healthcare System, West Haven, Connecticut.
FAU - Maron, Steven
AU  - Maron S
AD  - University of Chicago, Chicago, Illinois.
FAU - Connery, Donna
AU  - Connery D
AD  - Veterans Affairs Healthcare System, West Haven, Connecticut.
FAU - Gunduz-Bruce, Handan
AU  - Gunduz-Bruce H
AD  - Yale School of Medicine, Yale University, New Haven, Connecticut.
AD  - Veterans Affairs Healthcare System, West Haven, Connecticut.
FAU - Rose, Michal G
AU  - Rose MG
AD  - Yale School of Medicine, Yale University, New Haven, Connecticut.
AD  - Veterans Affairs Healthcare System, West Haven, Connecticut.
LA  - eng
GR  - T32 CA009566/CA/NCI NIH HHS/United States
PT  - Journal Article
DEP - 20150609
PL  - United States
TA  - Cancer Med
JT  - Cancer medicine
JID - 101595310
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Comorbidity
MH  - Female
MH  - Humans
MH  - Male
MH  - *Mental Health
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - Neoplasms/epidemiology/*pathology/*psychology
MH  - Population Surveillance
MH  - Retrospective Studies
MH  - *Veterans
PMC - PMC4567021
OTO - NOTNLM
OT  - Colorectal neoplasms
OT  - head and neck neoplasms
OT  - mental health
OT  - neoplasm staging
OT  - quality of health care
OT  - time factors
OT  - urologic neoplasms
OT  - veterans health
EDAT- 2015/06/13 06:00
MHDA- 2016/06/09 06:00
PMCR- 2015/09/01
CRDT- 2015/06/12 06:00
PHST- 2015/01/07 00:00 [received]
PHST- 2015/05/07 00:00 [revised]
PHST- 2015/05/12 00:00 [accepted]
PHST- 2015/06/12 06:00 [entrez]
PHST- 2015/06/13 06:00 [pubmed]
PHST- 2016/06/09 06:00 [medline]
PHST- 2015/09/01 00:00 [pmc-release]
AID - 10.1002/cam4.483 [doi]
PST - ppublish
SO  - Cancer Med. 2015 Sep;4(9):1365-73. doi: 10.1002/cam4.483. Epub 2015 Jun 9.