Graduation Date

Summer 8-19-2016

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Programs

Epidemiology

First Advisor

Shinobu Watanabe-Galloway

Abstract

Patients with head and neck cancer may be at increased risk for depression diagnosis when compared to other cancer sites, both before and after their cancer diagnosis. Behavioral risk factors for head and neck cancers, including tobacco and alcohol use, may be indicative of depression before cancer diagnosis. Further, head and neck cancers and their treatments can cause serious morbidity among patients, including physical disfigurement and loss of function. Additionally, these cancers are often accompanied by social stigma, personal shame, and guilt. While there is a significant body of research examining depression in this cancer population, there are still several gaps in the existing literature.

This dissertation explores the relationship between depression and head and neck cancer. Utilizing SEER-Medicare data, this research examines the rates of depression in the elderly adult head and neck cancer population, the influence that depression has on stage and survival, and the associations between radiation treatment side-effects and depression diagnosis. The results of the studies included in this dissertation may assist in guiding interventions for depression prevention and management in this population, and in improving cancer outcomes and quality of life for head and neck cancer patients.

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