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Jan. 4 (UPI) -- At least one in 10 patients with breast cancer requires treatment for depression, but don't get needed care unless oncologists screen them for the mental health disorder, a study published Tuesday by JAMA found. Conversely, about 1% of breast cancer patients in the study who were not screened for depression were diagnosed successfully with the mental health disorder, the data showed.
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The findings are based on an analysis of a program to identify cancer patients who need behavioral healthcare that was implemented in 2017 by the Kaiser Permanente health system, the researchers said.
The program successfully guided 75% of cancer patients with depression into needed treatment, they said.
"Early identification and treatment for mental health issues is critical, yet depression and other mental health issues are often underidentified and undertreated in breast cancer patients," study co-author Erin E. Hahn said in a press release.
"Our study showed that the use of implementation strategies to facilitate depression screening is highly effective ... [at helping] our cancer patients achieve the best possible health," said Hahn, a research scientist with Kaiser Permanente Southern California in Los Angeles.
More than 20 million people in the United States are diagnosed with depression annually, the National Institute of Mental Health estimates.
Research suggests that the disorder, which causes persistent feelings of sadness and loss of interest in daily activities, develops in about 25% of people with breast cancer.
Some forms of breast cancer treatment -- including chemotherapy, hormone therapy and the surgical removal of the ovaries -- increase the risk for depression in those with the disease, according to BreastCancer.org.
For this study, Hahn and her colleagues enrolled 1,436 breast cancer patients treated by oncologists at Kaiser Permanente between Oct. 1, 2017, and Sept. 30, 2018.
Of these participants, 692 were enrolled in the screening program to identify those with depression and refer them for needed care, the researchers said.
Those in the screening group were treated by physicians and nurses trained in depression screening and were administered a questionnaire designed to assess them for symptoms of the mental health disorder, according to the researchers.
Participants in the other group were treated by physicians and nurses who received training on the importance of screening for depression, but were not asked to screen patients formally.
Of participants in the screening group, 80% completed depression screening, compared with less than 1% in the non-screening group, the data showed.
In the screening group, among those who completed depression screening, 10% had scores that indicated a need for mental health services. Of those, 94% received referrals from their oncologists and 75% completed a visit with a mental health provider, the researchers said.
In addition, patients in the screening group needed fewer oncology clinic visits, the data showed.
"The trial of this program was so successful that ... we have rolled out depression screening initiatives across all our Kaiser Permanente medical oncology departments in Southern California," study co-author Hahn said.
"We are incorporating the lessons learned from the trial, particularly the importance of ongoing audit and feedback of performance and are encouraging our clinical teams to adapt the workflow to meet their needs," she said.
