Presentation (CTI)

OBJECTIVES: The incidence of colorectal cancer (CRC) is increasing in young adults. Given associations between mental health (MH) burdens and cancer, this study assessed the potential incremental impact of early onset CRC by evaluating the change in MH utilization pre- to post-CRC diagnosis based on age.
METHODS: Patients aged ≥20 newly diagnosed with CRC were identified in the Merative^TM MarketScan^® Commercial and Medicare Databases. Index was the first CRC claim and patients had continuous eligibility with medical and MH benefits for 12-months prior and following. MH diagnoses (adjustment disorder, anxiety, depression), MH provider visits, and MH diagnosis-related costs were examined in the pre- and post-periods among patients aged 20-44, 45 to 64, or ≥65 years at diagnosis.
RESULTS: Analyses included 10,751 CRC patients (11.2% 20-44; 67.7% 45-64; 21.1% ≥65). Increased MH utilization was observed following CRC diagnosis with the greatest increases in younger patients. The 20-44, 45-64, and ≥65 groups had respective pre-to-post increases in the prevalence of adjustment disorder (6.2%, 2.3%, and 1.8%), anxiety (16.6%, 12.1%, and 7.3%), and depression (9.8%, 7.2%, and 7.3%). Overall utilization of MH care increased as well, with the proportion of patients with ≥1 office visit with a MH provider increasing 6.5% in the 20-44 group, 2.9% in the 45-64 group, and 2.3% in the ≥65 group. Increases in mean MH diagnosis-related costs were also observed from the pre-to-post-periods with a 16-fold ($760 to $12,242) in the 20-44 group, a 12-fold increase ($672 to $8,328) in the 45-64 year group, and a 6-fold increase ($707 to $4,149) in the ≥65 group.
CONCLUSIONS: This study demonstrates increasing MH burdens with CRC diagnosis, especially in patients with early onset disease. Results highlight the need for integration mental healthcare into cancer care. Proactive provision of mental healthcare may help to both improve patient outcomes and reduce economic burdens.