Mental health among nonelderly adult cancer survivors: A national estimate

Cancer. 2020 Aug 15;126(16):3768-3776. doi: 10.1002/cncr.32988. Epub 2020 Jun 15.

Abstract

Background: This study assessed mental health (MH) outcomes across age groups in a nationally representative US sample of adult cancer survivors.

Methods: The 2015 to 2017 National Survey on Drug Use and Health was used to identify respondents aged 18 to 64 years. The authors compared MH outcomes between respondents with a cancer history and respondents without a cancer history in adjusted analyses controlling for demographics and socioeconomic status. Outcomes included past-year major depressive episodes, serious psychological distress, suicidal thoughts, suicidal plans, suicidal attempts, any mental illness, and serious mental illness. All analyses were stratified by age group (18-34, 35-49, or 50-64 years).

Results: In a comparison of 2656 survivors and 112,952 individuals without cancer, within each age group, survivors had an elevated prevalence of MH problems in 5 of the 7 outcome measures. Among young adults (aged 18-34 years), survivors were more likely than noncancer counterparts to experience major depressive episodes (18.1% vs 9.6%), serious psychological distress (34.2% vs 17.9%), suicidal thoughts (10.5% vs 7.0%), any mental illness (41.1% vs 23.3%), and serious mental illness (13.2% vs 5.9%) in the past year (P values <.05). These differences persisted in adjusted analyses (P values <.01). Similar survivor-comparison differences were observed among older groups but with a smaller magnitude. Among survivors, young adult survivors had the highest likelihood of experiencing MH problems across all outcomes (P values <.05).

Conclusions: This population-based study shows an elevated prevalence of MH problems among adult cancer survivors in comparison with the general population. This finding highlights the importance of developing strategies to ensure the early detection of mental illness and to improve access to MH treatment for cancer survivors.

Keywords: cancer survivors; mental health; national estimates; survivorship; young adult survivors.

MeSH terms

  • Adolescent
  • Adult
  • Cancer Survivors / psychology
  • Depressive Disorder, Major / epidemiology*
  • Depressive Disorder, Major / pathology
  • Female
  • Humans
  • Male
  • Mental Health*
  • Middle Aged
  • Neoplasms / epidemiology*
  • Neoplasms / physiopathology
  • Substance-Related Disorders / epidemiology*
  • Substance-Related Disorders / pathology
  • Suicidal Ideation
  • Young Adult