title: Mental health services utilization and expenditures associated with cancer survivorship in the United States.
abstract: OBJECTIVE
  The aim of this study is to assess mental health services utilization and expenditures associated with cancer history using a nationally representative sample in the US.
  
  
  METHODS
  We used data from the 2008-2011 Medical Expenditure Panel Survey and multivariate regression models to assess mental health services use and expenditures among cancer survivors compared to individuals without a cancer history, stratified by age (18-64 and ≥65 years) and time since diagnosis (≤1 vs. >1 year).
  
  
  RESULTS
  Among adults aged 18-64, compared with individuals without a cancer history, cancer survivors were more likely to screen positive for current psychological distress and depression regardless of time since diagnosis; survivors diagnosed >1 year ago were more likely to use mental health prescription drugs; those diagnosed within 1 year reported significantly lower annual per capita mental health drug expenditure and out-of-pocket mental health expenditure, while those diagnosed >1 year presented significantly higher annual per capita mental health expenditure. No significant differences in mental health expenditures were found among adults aged 65 or older.
  
  
  CONCLUSIONS
  Mental health problems presented higher health and economic burden among younger and longer-term survivors than individuals without a cancer history. This study provides data for monitoring the impact of initiatives to enhance coverage and access for mental health services at the national level.
  
  
  CONCLUSIONS
  Early detection and appropriate treatment of mental health problems may help improve quality of cancer survivorship.
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F-76, Atlanta, GA, 30341-3724, USA, cli11@cdc.gov.
authors.forename: Chunyu
authors.initials: C
authors.lastname: Li
authors.forename: Chenghui
authors.initials: C
authors.lastname: Li
authors.forename: Laura
authors.initials: L
authors.lastname: Forsythe
authors.forename: Catherine
authors.initials: C
authors.lastname: Lerro
authors.forename: Anita
authors.initials: A
authors.lastname: Soni
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000191:economics*; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics / Q000401:mortality / Q000523:psychology*; D017741:Survivors; D014481:United States; D055815:Young Adult
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