WASHINGTON – Cancer survivors are almost twice as likely to be taking medication for anxiety, depression, or both, compared with people who have never had cancer, according to investigators from the Centers for Disease Control and Prevention.
Data from a national survey of more than 48,000 adults show that 15.1% of cancer survivors reported taking drugs for anxiety, and 14% reported taking depression medications, compared with 8.7% and 7.9%, respectively, of adults who never had a cancer diagnosis, reported Nikki A. Hawkins, Ph.D., a behavioral scientist in the CDC’s division of cancer prevention and control.
Nikki Hawkins, Ph.D.
“We do know that there is a large population of cancer survivors in the U.S. taking these medications for anxiety and depression, which likely reflects the elevated emotional burden on this population,” she said at the joint congress of the International Psycho-Oncology Society and the American Psychosocial Oncology Society.
Dr. Hawkins and her colleagues examined data from the National Health Interview Survey, a nationwide sample of approximately 35,000 U.S. households containing information on about 87,500 people.
The survey asks whether adult participants ever had cancer, the type, and their age at diagnosis, and includes questions about health behaviors such as smoking, as well as access to health care and utilization of preventive and screening services such as human-papillomavirus vaccination and Pap smear for cervical cancer prevention/detection, mammography for breast cancer screening, and fecal occult blood testing, sigmoidoscopy, or colonoscopy for colorectal cancer screening.
Since 2010, a subset of survey participants has been asked questions about functioning and disability, including physical domains (vision, hearing, mobility, etc.), and affect, including whether they take medications for depression and/or “for feeling worried, nervous, or anxious.”
The investigators included those who took part in the survey from 2010 through 2013, including 3,184 cancer survivors and 44,997 controls (no cancer diagnosis).
Sites of most recent cancer diagnoses include breast (in women), prostate, skin (melanoma), cervix, colorectal, hematologic, ovary/uterus, and other.
In all, 15% of patients had been diagnosed within the past 2 years, 29% from 2 to 5 years, 21% from 6 to 10 years, and 36% 11 or more years (numbers exceed 100% because of rounding).
Nearly twice as many cancer survivors reported taking medication for depression or anxiety, compared with the controls: 18% of survivors reported taking either of the medications, compared with 10.4% of controls. This translates into an estimate for the overall U.S. population of 2,383,954 cancer survivors taking medication for either anxiety or depression, Dr. Hawkins said.
Factors predictive of depression or anxiety medication use among cancer survivors included being female, white, non-Hispanic, age younger than 65 years, having never been married, lower levels of education, having a usual place for medical care, and a having a higher number of chronic health conditions.
With the exception of levels of education, the same factors were also predictive of anxiety and/or medication use among controls, the investigators found.
The study was limited by the use of self-reported survey data, and lack of information on the onset or duration of medication use, specific medications taken, or use of other nonpharmacologic therapies for anxiety or depression, Dr. Hawkins acknowledged.
Nonetheless, “these estimates can serve as a benchmark for medication use among the U.S. cancer survivor population, and moving forward, it will be important to look at the duration and onset of use to see exactly when the increase in medication happens and why it happens at that time,” she said.