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Abstract
Introduction: Pediatric cancer patients suffer mental health deficits. Patients who are vulnerable with respect to socioeconomic or other sociodemographic factors may be at heightened risk for worse mental health outcomes during cancer for many reasons including entering treatment with an existing mental health disorder. The purpose of this study was to describe the prevalence and trajectory of mental health before and after a childhood cancer diagnosis in a socio-demographically at-risk sample.
Methods: Data from the Kentucky Cancer Registry was utilized to identify patients aged 19 or under with a first primary childhood cancer diagnosis during 2001–2017. Linking KCR data with Medicaid claims, we included patients with continuous Medicaid enrollment 12 months before and after their cancer diagnosis. MHDs were identified using both International Classification of Diseases (ICD)-9 and ICD-10 diagnosis codes in Medicaid claims.
Results: Of the 978 patients, 54% were male, and 39% were from Appalachian counties. The most common cancers diagnosed were leukemias (n = 238), brain and central nervous system (n = 220), and lymphomas (n = 147). For the 12-month pre-cancer diagnosis period, 32% (n = 310) of the patients had a MHD, increasing to 55% (n = 540) in the 12 months post-diagnosis period. The most frequent MHDs were mood disorder (before n = 120; after n = 311) and neuropsychiatric/developmental disorders (before n = 228; after n = 267). Mood disorders increased from 12% pre-cancer diagnosis to 32% post-cancer diagnosis, from 10 to 37% for lymphoma patients, and from 15 to 64% for bone cancer patients.
Conclusion: Over half of the Medicaid-enrolled childhood cancer patients in Kentucky diagnosed with MHDs within a year of their cancer diagnosis, with a notable increase from pre-diagnosis levels. This increased prevalence post-diagnosis may result from the identification of pre-existing MHDs during cancer treatment, or the emergence of new MHD because of the cancer diagnosis and treatment. Our study highlights the psychosocial needs that extend beyond standard cancer treatment and underscores the importance of psychosocial services during and after the cancer treatment period.
Document Type
Article
Publication Date
2026
Digital Object Identifier (DOI)
https://doi.org/10.3389/fpsyg.2025.1680382
Funding Information
The author(s) declared that financial support was received for this work and/or its publication. This work is supported in part by the National Institutes of Health (NIH) (Grant numbers P30CA177558 and SEER HHSN26100001), the Centers for Disease Control and Prevention (CDC) (Grant number NPCR 1NU58DP007144-01-00), and funding support from the Commonwealth of Kentucky.
Repository Citation
Lei, Feitong; McLouth, Laurie E.; Durbin, Eric B.; Tucker, Thomas T.; Villano, John L.; and Huang, Bin, "Prevalence and characteristics for mental health disorder before and after childhood cancer diagnosis—a statewide population-based study among Medicaid beneficiaries" (2026). Internal Medicine Faculty Publications. 291.
https://uknowledge.uky.edu/internalmedicine_facpub/291
Notes/Citation Information
© 2026 Lei, McLouth, Durbin, Tucker, Villano and Huang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.