National estimates of mental health service use and unmet needs among adult cancer survivors

Cancer. 2021 Nov 15;127(22):4296-4305. doi: 10.1002/cncr.33827. Epub 2021 Aug 11.

Abstract

Background: Cancer survivors are at elevated risk for developing mental health (MH) disorders. This study assessed MH service use and unmet service needs among a nationally representative sample of cancer survivors.

Methods: Respondents aged 18 to 64 years were identified from the 2015-2018 National Survey of Drug Use and Health data. Outcomes assessed past-year MH service use and self-reported unmet MH needs. Outcomes were compared between respondents who reported a cancer history (survivors) and those who did not (controls), descriptively and in adjusted analyses controlling for sociodemographic factors and health status. Analyses were stratified by age groups (18-34, 35-49, and 50-64 years).

Results: Comparing 3540 survivors with 149,843 controls, within each age group, a higher proportion of survivors than controls received any MH service (P values < .05); this difference persisted among those aged 35 to 49 years (P = .004) in fully adjusted models. Moreover, a higher proportion of survivors than controls reported an unmet need for MH care; this difference was larger among young adults aged 18 to 34 years (20.8% vs 9.0%; P < .001) than those aged 35 to 49 years (9.4% vs 5.3%; P < .001) and 50 to 64 years (4.8% vs 3.4%; P = .029). In fully adjusted models, the survivor-control difference in self-reported unmet MH needs persisted among young adults (24% relative increase; P = .023). Among cancer survivors, young adult survivors had the highest likelihood of reporting unmet MH needs.

Conclusions: This nationally representative study found an increased perception of unmet needs for MH care among cancer survivors, particularly among young adult survivors, compared with the general population without cancer.

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

MeSH terms

  • Adolescent
  • Adult
  • Cancer Survivors* / psychology
  • Health Services Needs and Demand
  • Humans
  • Mental Health Services*
  • Middle Aged
  • Neoplasms* / epidemiology
  • Neoplasms* / psychology
  • Neoplasms* / therapy
  • Surveys and Questionnaires
  • Survivors / psychology
  • Young Adult