Incidence of New Mental Health Diagnosis in Testicular Cancer Survivors

Abstract

Objective: To evaluate incidence of mental health disorder (MHD) diagnosis after orchiectomy in testicular cancer patients and identify factors associated with MHD.

Methods: Using claims from the IBM Marketscan database, we identified patients 18 years or older diagnosed with testicular cancer between 2009 and 2021 who underwent orchiectomy, had no prior MHD diagnoses, and maintained insurance coverage spanning 6months before and 12months after diagnosis. Chemotherapy and RPLND were defined as advanced treatments. We identified insurance claims associated with diagnoses of MHD at 12 and 36months after orchiectomy. Factors predicting the cumulative incidence of MHD were analyzed using multivariable regression. Male patients with no lifetime cancer diagnosis and 4years of continuous insurance coverage were identified as controls and matched by demographics.

Results: Of all 5881 patients, 507 (8.6%) and 909 (13.9%) had a new diagnosis of MHD within 12 and 36months of orchiectomy, respectively. The cumulative incidence of MHD was significantly different among cases and controls over 12months (9.2% vs 2.2%, P<.0001) and 36months (14.8% vs 7.3%, P<.0001). In the multivariable regression, factors associated with new diagnosis of MHD were younger age, more recent year of diagnosis, higher CCI, and receipt of advanced treatment.

Conclusion: Testicular cancer patients have a higher incidence of developing MHD compared to age-matched controls. Physicians should counsel patients prior to orchiectomy regarding the risk of developing MHD, understand factors associated with likelihood of MHD incidence, and refer patients to receive appropriate interventions as needed postoperatively.