Preexisting Mental Illness Associated with Elevated Mortality Risk among Medicaid-Insured Women with Breast Cancer

ALBANY, N.Y. (February 24, 2021) – In a recent study, UAlbany School of Public Health alum (DrPH, 2020) Dr. Wayne Lawrence collaborated with several faculty to investigate the impact of preexisting mental illnesses on all-cause and cause-specific mortality among Medicaid-insured women diagnosed with breast cancer. The researchers discovered that among women diagnosed with breast cancer, those with preexisting severe mental illness (SMI) at diagnosis were at an increased risk of overall mortality and cancer-specific mortality compared to women without mental illness.    

This retrospective study linked New York State Department of Health Cancer Registry and Medicaid Program data and included 10,444 women less than 64 years of age diagnosed with breast cancer from 2004 to 2016. The Cancer Registry-Medicaid linkage allowed for assessment of cancer stage, vital status, Medicaid enrollment, and medical care utilization. The researchers defined preexisting SMI (bipolar disorder, schizophrenia, major depressive disorder, and other psychotic disorders) and preexisting depression based on the presence of at least three relevant diagnosis claims with at least one claim occurring within three years prior to their breast cancer diagnosis.    

Their findings revealed that cancer-specific mortality hazard was more than 20% higher among women with preexisting SMI compared to those without mental illness at breast cancer diagnosis. Of note, mortality hazards were greatest among women with preexisting SMI who were obese, postmenopausal, and tobacco users.    

The authors hope that the findings from this study will be useful to clinical teams treating breast cancer among women with mental illness at breast cancer diagnosis.