OBJECTIVES

: To evaluate the burden of mental health conditions among youths who experiencing an older family member diagnosed with cancer. To assess the risk factors that associate with newly diagnosed mental health disorders in the United States.

METHODS

: The study was a retrospective cohort study using the Truven MarketScan® database. Eligible children and young adults (ages ≤26 years) with no history of mental health conditions with adult family members newly diagnosed with lung, colorectal, blood, prostate and female breast cancer (2012-2014). Occurrence of incident mental health conditions were identified and grouped as emotional disorders, psychosis and behavioral disorders. Cox proportional hazards models were used to determine characteristics associated with mental health disorders.

RESULTS

: Among 41,755 eligible children and young adults, the median age was 17 years, 49.2 were female and 12.9% had new diagnoses for mental health conditions following the familial cancer event. A total of 2,031 (4.8%) patients had emotional disorders, 927 (2.2%) had psychosis and 2,455 (5.9%) had behavioral disorders. The for any mental health disorders were 8.3 (95% confidence interval [CI] 8.0-8.6) and 9.3 (95%CI 9.0-9.6) per 100 person-year in male and female subjects, respectively.

In multivariable analyses, rates of mental health disorders were greater among female children and young adults (hazard ratio, HR=1.13, 95%CI 1.07-1.20). Young adults (ages 18-26) were more likely to develop mental disorders compared to children ages <18 (HR=1.17, 95%CI 1.08-1.28). More children and young adult dependents (HR=0.93, 95%CI 0.90-0.96) and three or more adult family members (HR=0.92, 95%CI 0.86-0.99) in the same household were associated with lower rates of incident mental conditions.

CONCLUSIONS

: A substantial number of children and young adults are diagnosed with an incident mental health condition following an adult family member’s cancer event. Clinicians should consider screening be cognizant of the mental health disorders among younger family members of newly diagnosed cancer patients.