Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Division of Gastroenterology, Duke University School of Medicine, Durham, North Carolina.
Cancer Epidemiol Biomarkers Prev. 2021 Jun;30(6):1122-1128. doi: 10.1158/1055-9965.EPI-20-1683. Epub 2021 Apr 13.
Colorectal and other digestive cancer survivors are at increased risk of depression, which can negatively affect health outcomes. Food insecurity (FI), the lack of consistent access to enough food, can also contribute to these health complications. The objective of this study was to determine the relationship between FI and depressive symptoms within this population.
We conducted a cross-sectional analysis of data from the 2007-2016 National Health and Nutrition Examination Survey. We included all adults (≥20 years) with a self-reported history of a digestive cancer (including colorectal, esophageal, stomach, liver, and pancreas cancer). Our primary exposure was household FI, and our outcome of interest was depressive symptoms, as measured by the validated 9-item Patient Health Questionnaire. We used multivariable ordinal logistic regression to test the association between FI and depressive symptoms, controlling for demographic and clinical covariates.
We included 229 adult digestive cancer survivors (weighted = 1,510,579). The majority of the study sample was female and non-Hispanic White with mean of 11.0 years since cancer diagnosis; 14.3% reported FI. In multivariable models controlling for demographic and clinical covariates, we found that food insecure digestive cancer survivors had significantly higher odds of depressive symptoms than food secure digestive cancer survivors (OR: 3.25; 95% confidence interval: 1.24-8.55; = 0.02).
Among a nationally representative sample of colorectal cancer and other digestive cancer survivors, FI was associated with increased odds of depressive symptoms.
This study adds further evidence to the negative impact FI may have on survivors' physical and mental health.
结直肠癌和其他消化系统癌症幸存者患抑郁症的风险增加，这可能对健康状况产生负面影响。食品不安全（FI），即无法持续获得足够的食物，也可能导致这些健康并发症。本研究的目的是确定该人群中 FI 与抑郁症状之间的关系。
我们对 2007-2016 年全国健康与营养调查的数据进行了横断面分析。我们纳入了所有有消化系统癌症（包括结直肠癌、食管癌、胃癌、肝癌和胰腺癌）自我报告史的成年人（≥20 岁）。我们的主要暴露因素是家庭 FI，我们感兴趣的结果是抑郁症状，用经过验证的 9 项患者健康问卷进行测量。我们使用多变量有序逻辑回归来检验 FI 与抑郁症状之间的关联，同时控制人口统计学和临床协变量。
我们纳入了 229 名成年消化系统癌症幸存者（加权 = 1,510,579）。研究样本的大多数是女性和非西班牙裔白人，癌症诊断后平均 11.0 年；14.3%的人报告有 FI。在控制人口统计学和临床协变量的多变量模型中，我们发现与食物安全的消化系统癌症幸存者相比，食物不安全的消化系统癌症幸存者出现抑郁症状的几率显著更高（OR：3.25；95%置信区间：1.24-8.55；p = 0.02）。
在一个具有全国代表性的结直肠癌和其他消化系统癌症幸存者样本中，FI 与抑郁症状的几率增加相关。
本研究进一步证明了 FI 可能对幸存者身心健康产生负面影响。
