Cancer stage at diagnosis by duration of pre-existing chronic analgesic use and anxiety or depression

TL;DR

This study finds that the timing and duration of chronic analgesic use and mental health conditions like anxiety or depression can influence the stage at which lung or colon cancer is diagnosed.

Contribution

The study introduces a novel analysis of how the duration of pre-existing chronic conditions affects cancer stage at diagnosis.

Findings

Recent-onset analgesic use is linked to higher odds of advanced stage lung or colon cancer.

Persistent analgesic use is associated with lower odds of advanced stage lung cancer.

Persistent anxiety or depression is linked to lower odds of advanced stage lung or colon cancer.

Abstract

Pre-existing chronic diseases may delay or expedite cancer diagnosis. Here, we examine variations in cancer stage at diagnosis based on duration and type of common chronic conditions. We identify lung and colon cancers diagnosed 2012-2018 from national cancer registration, and pre-existing physical and mental-health conditions from linked primary care records. Using multivariable logistic regression, we explore associations between the most prevalent conditions (Anxiety/Depression and Chronic Analgesic Medication use), classified as “Recent-onset” (first recorded <12months pre-cancer) or “Persistent/Historic” (12-72 months pre-cancer), and cancer stage at diagnosis. We show that recent-onset Analgesic Medication use can be associated with increased odds of advanced stage lung or colon cancer diagnosis. Conversely, persistent/historic Chronic Analgesic Medication use can be associated with reduced odds of advanced stage lung cancer and persistent/historic Anxiety/Depression with reduced odds of advanced stage lung or colon cancer. Persistent or historic conditions may increase healthcare utilisation, offering opportunities for early cancer diagnosis. Recent-onset conditions may lead to delays through the alternative explanations or competing demands mechanisms.

Pre-existing chronic diseases can delay or accelerate cancer diagnosis. Here the authors report that the duration of analgesic treatment as well as history of anxiety or depression can impact risk of advance stage lung and colon cancer in patients.

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