P0033 - Impact of Psychiatric Illness on Cholangiocarcinoma Screening and Outcome in a Safety-Net Hospital

Sherif Saleh, MD, Neethi Paranji, MD, Josue Davila, MD, Bolin Niu, MD
MetroHealth Medical Center, Cleveland, OH

Introduction: Psychiatric illnesses among patients with cancer have been linked to decreased adherence to treatment regimens and worse outcomes. However, the association between psychiatric illness and cholangiocarcinoma (CCA) is unclear. We aim to investigate the incidence of psychiatric illness in patients with CCA and its impact on disease outcomes.

Methods: We performed a manual chart review of all patients diagnosed with CCA from 2010 to 2019 at a major safety-net hospital. Patients with CCA were divided into two cohorts based on the presence or absence of concurrent psychiatric illness. Statistical analyses were performed using Statistical Product and Service Solutions version 26.0 (SPSS, Inc., Chicago, Illinois). Qualitative and quantitative differences between groups were analyzed by Chi-squared or Fisher’s exact tests for categorical variables and t-test for continuous variables.

Results: A total of 46 patients with a diagnosis of CCA were included. Of these, 17 patients (37%) had a concurrent psychiatric illness. Adequate screening, defined as radiologic imaging within six months prior to diagnosis, was more likely to occur in patients with psychiatric illness (52.9%) compared to those without (24.1%) (p=0.038). Moreover, patients without psychiatric illness had a higher MELD score at the time of diagnosis of CCA when compared to patients with psychiatric illness (15.2 vs 6.5, p=0.039). However, there was no significant difference in baseline characteristics, mortality, presence of metastases, or tumor board treatment recommendations between the groups (Table).

Discussion: In our center, patients with psychiatric illness were more likely to undergo adequate screening for hepatic neoplasia than patients without psychiatric illness, perhaps due to better linkage to care from our community outreach programs. Despite this, there was no significant difference in the age at diagnosis, mortality, and treatment recommended by a multidisciplinary tumor board for those with and without psychiatric illness. In addition, although patients without psychiatric illness had higher MELD at diagnosis of CCA, this did not appear to translate into worse clinical outcomes. In summary, our study suggests cirrhotic patients with psychiatric illness can benefit from adequate screening and linkage to care.



Disclosures:


Sherif Saleh, MD, Neethi Paranji, MD, Josue Davila, MD, Bolin Niu, MD. P0033 - Impact of Psychiatric Illness on Cholangiocarcinoma Screening and Outcome in a Safety-Net Hospital, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.