Preexisting Psychological Illness and Its Association with Mortality in Lung Cancer Patients with Access to Support Resources

Abstract Introduction: Diagnosis of lung cancer often results in tremendous stress for most patients, especially in patients with underlying psychological illness. Psy- chosocial support (consultation with psychologist, psychotherapist, or social worker) referral is considered standard for quality cancer care; however, which patients utilize these resources and how these resources affect patient out- comes remain unclear. Objectives: We aimed to identify which newly diagnosed lung cancer patients accessed available psychosocial resources and assessed how utilization of these resources correlated with treatment and survival outcomes. Methods: Data were collected from National Cancer Institute-designated can- cer center at the University of New Mexico. We analyzed lung cancer registry and mortality data at the cancer center and bronchoscopy suite data to retro- spectively identify patients diagnosed with lung cancer between 2012 and 2017. We used a logistic regression model to compare psychological support utilization at the cancer center between patients with and without history of psychiatric illness. We used a Cox proportional hazards model to identify indi- vidual risk factors for mortality. Results: Patients with a previous psychological diagnosis were 2.4 times more likely (odds ratio = 2.443; confidence interval [CI], 1.130–5.284) to utilize psy- chological resources than patients without a pre-cancer psychological diagno- sis. Patients who received psychosocial intervention had a 120.4% higher hazard of dying than those who did not (hazard ratio = 2.204; 95% CI, 1.240– 3.917). One-year survival probability among those who did not utilize resources was 62.65% (95% CI, 55.24%–71.06%) and 43.0% (95% CI, 31.61%– 58.50%) among those who did. Patients with a previous psychiatric diagnosis were more likely to utilize psychosocial resoures within 1 year of lung cancer diagnosis.