TOPLINE:

Cancer survivors used antidepressants and anxiolytics more often than other US adults, according to recent data from the National Health Interview Survey. But non-Hispanic Black survivors were significantly less likely to use these medications than their non-Hispanic White counterparts.

METHODOLOGY:

• Depression and anxiety affect a substantial proportion of cancer survivors and are linked to worse long-term outcomes. Sociodemographic factors affect access to mental healthcare, but their association with the use of antidepressants and anxiolytics among cancer survivors remains unclear.
• Researchers conducted a cross-sectional study using data of 53,117 respondents (age, 18-85 years) from the US who participated in the National Health Interview Survey (2016-2018).
• Overall, 48,026 individuals had no history of cancer (41.8% aged 40-64 years; 17.2% Hispanic, 12.2% non-Hispanic Black, and 61.6% non-Hispanic White; 51.2% women), while 5091 individuals reported ever receiving a cancer diagnosis (37.7% aged 40-64 years; 6.3% Hispanic, 7.1% non-Hispanic Black, and 81.7% non-Hispanic White; 57.5% women).
• The two primary outcomes were the use of antidepressants, determined from the survey question “Do you take medication for depression?” and the use of anxiolytics, determined from the question “Do you take medication for anxiety?”
• The researchers also evaluated associations between sociodemographic factors (race, ethnicity, type of insurance coverage, and marital status), as well as cancer type and the use of antidepressants and anxiolytics among cancer survivors.

TAKEAWAY:

• Among respondents with a history of cancer, 748 (13.8%) reported antidepressant use and 783 (14.5%) reported anxiolytic use compared with 4551 (8.3%) and 4838 (8.9%) respondents without a cancer history, respectively. After adjustment, cancer survivors had higher odds of using antidepressants (adjusted odds ratio [aOR], 1.32; P < .001) and anxiolytics (aOR, 1.38; P < .001) than respondents without a cancer history.
• Among cancer survivors, non-Hispanic Black respondents were less likely than non-Hispanic White respondents to use medications for depression (aOR, 0.60; P = .02) or anxiety (aOR, 0.63; P = .03).
• As for other sociodemographic factors, medication use was more common among survivors covered by Medicare (aOR, 4.36 for antidepressants; 2.20 for anxiolytics) or Medicaid (aOR, 2.64 for antidepressants; 1.83 for anxiolytics) than those with private insurance. Unmarried survivors also had higher use than married survivors (aOR, 1.45 for antidepressants; 1.41 for anxiolytics).
• Certain cancer types were associated with higher rates of medication use. Compared with breast cancer survivors, respondents with a history of brain cancer were more likely to use antidepressants (aOR, 5.59; P = .003), while pancreatic cancer survivors were more likely to use either antidepressants (aOR, 5.30; P = .006) or anxiolytics (aOR, 6.74; P = .001).

IN PRACTICE:

“In this study, cancer survivors were significantly more likely to take medications for depression and anxiety compared with noncancer survivors, underscoring the importance of mental health in cancer,” the authors wrote. 

However, “disparities by race and ethnicity still existed in the use of these medications,” the authors said. “Given the potential impact that depression and anxiety can have on treatment outcomes, it is important to ensure equitable access to mental health[care] for all cancer survivors independent of sociodemographic differences.”

SOURCE:

The study, led by Daniela Miro-Rivera, Yale College, Yale University, New Haven, Connecticut, and Ryan A. Norris, Morehouse College, Atlanta, was published online in JAMA Network Open.

LIMITATIONS:

Non-Hispanic White respondents made up nearly 82% of the cancer cohort. The study did not distinguish between cancer stages, time since diagnosis, or disease severity, factors that could influence depression and anxiety rates. Additionally, the study lacked information on potential factors contributing to the observed disparities.

DISCLOSURES:

The research was conducted as part of the Duke Center for Research to Advance Healthcare Equity Summer Undergraduate Research Program, supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health (NIH) and Duke University School of Medicine. One author reported receiving grants from the NIH National Institute of Dental and Craniofacial Research (NIDCR) during the study, and grants from NIH NIDCR and personal fees from Navigating Cancer and Merck, outside the submitted work. No other disclosures were reported.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.