title: Current depression among adult cancer survivors: findings from the 2010 Behavioral Risk Factor Surveillance System.
abstract: BACKGROUND
  A cancer diagnosis and subsequent treatments constitute a significantly increased psychological burden among cancer patients. This study examined the prevalence of current depression and the risk factors associated with a high burden of depression among cancer survivors in the US.
  
  
  METHODS
  We analyzed data from 3550 cancer survivors (aged ≥ 18 years) and 26,917 adults without cancer who participated in the 2010 Behavioral Risk Factor Surveillance System. Depressive symptoms were assessed by the Patient Health Questionnaire-8 diagnostic algorithm. Participants with a total depression severity score of ≥ 10 were defined as having current depression. Prevalence and prevalence ratios were estimated by conducting log-linear regression analysis while controlling for potential confounders.
  
  
  RESULTS
  Overall, 13.7% of cancer survivors (vs. 8.9% of adults without cancer, P < 0.001) reported having current depression; the prevalence varied significantly by cancer category. Among cancer survivors, after multivariate adjustment for covariates, cancer diagnosis within a year, being in 'other' racial/ethnic group, divorced, separated, widowed, or never married, current or former smoker, or having histories of diabetes, disability, or depression were associated with significantly higher prevalence ratios for current depression; whereas being at an advanced age (≥ 60 years old), attaining educational levels of >high school graduate, or engaging in leisure-time physical activity were associated with significantly lower prevalence ratios for current depression.
  
  
  CONCLUSIONS
  Our results indicate that cancer survivors are at increased risk of current depression. Targeting cancer survivors at high risk of depressive issues may be especially important for clinical support and interventions aimed at improving mental well-being.
authors.affiliation: Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30345, USA. Electronic address: GZhao@cdc.gov.
authors.forename: Guixiang
authors.initials: G
authors.lastname: Zhao
authors.affiliation: Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30345, USA.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Okoro
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30345, USA.
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30345, USA.
authors.forename: Arica
authors.initials: A
authors.lastname: White
authors.affiliation: Northrop Grumman Corporation, Atlanta, GA 30345, USA.
authors.forename: Satvinder
authors.initials: S
authors.lastname: Dhingra
authors.affiliation: Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30345, USA; Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30345, USA.
authors.forename: Chaoyang
authors.initials: C
authors.lastname: Li
mesh_terms: D040343:Behavioral Risk Factor Surveillance System; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000523:psychology*; D012307:Risk Factors; D017741:Survivors / Q000523:psychology*
keywords: BRFSS; Cancer survivor; Current depression; Depressive symptoms; Patient Health Questionnaire-8 (PHQ-8)