The Relationship Between Diagnosed Cancer and Self-Reported Distress and Depression: A Cross-Sectional Study Using the 2020 Medical Expenditure Panel Survey.
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BACKGROUND: Many adults in the United States (U.S.) are diagnosed with cancer at some point in their lifetime, and new mental health diagnoses are common after diagnosis. We explored the association between ever being diagnosed with cancer and mental health issues of adults during 2020. AIMS: To investigate the association between ever been diagnosed with cancer and self-reported mental health among adults and to examine whether race, ethnicity, and sex moderated this relationship. METHODS: Using 2020 Medical Expenditure Panel Survey data of adults (age 18+) (n = 8,754, unweighted), we conducted descriptive statistics and estimated bivariate and multivariable logistic regressions to explore the association of diagnosed cancer and self-reported psychological distress and depression, controlling for race, ethnicity, sex, demographic/sociodemographic, and health-related controls. We included interaction terms of cancer diagnosis and: race, ethnicity, and sex. RESULTS: Prevalences were similar for adults with and without cancer for moderate/serious distress (22.4% vs. 24.1%) and depression symptoms (19.5% vs. 19.9%). We did not find a statistically significant association between cancer and mental health outcomes. Race, ethnicity, and sex did not moderate the relationship between diagnosed cancer and self-reported mental health outcomes. CONCLUSIONS: U.S. adults with cancer in 2020 had high prevalence of distress and depression but were not more likely to report mental health outcomes than adults without cancer after controlling for measured confounding. Results suggest routine, equitable mental health screening is needed within oncology and primary care. Future research should explore COVID-19 pandemic impacts on cancer and mental health, and differences by race, ethnicity, and sex of recently diagnosed patients.