Miro-Rivera Daniela, Norris Ryan A, Osazuwa-Peters Oyomoare L, Hurst Jillian H, Barnes Justin M, Osazuwa-Peters Nosayaba
Yale College, Yale University, New Haven, Connecticut.
REACH Equity Summer Undergraduate Research Program, Duke University School of Medicine, Durham, North Carolina.
JAMA Netw Open. 2025 Aug 1;8(8):e2527585. doi: 10.1001/jamanetworkopen.2025.27585.
Depression and anxiety disproportionately impact cancer survivors. Sociodemographic factors frequently impact access to cancer care; however, it is unclear if these factors are associated with access to pharmacological care for mental and behavioral health conditions.
To evaluate antidepressant and anxiolytic use among cancer survivors compared with the general US population and identify associations between sociodemographic factors and medication use.
DESIGN, SETTING, AND PARTICIPANTS: For this cross-sectional study, data from 2016 to 2018 from the National Health Interview Survey were analyzed in January 2024. The nationally representative, population-based sample consisted of respondents to the National Health Interview Survey aged 18 to 85 years without a history of cancer residing in the US.
Eligible respondents completed the Adult Functioning and Disability supplements and had nonmissing outcomes. Self-reported antidepressant and anxiolytic use were the main outcomes, estimated through multivariable logistic regression analyses, adjusting for sociodemographic factors.
Among 53 117 respondents, 48 026 individuals (21 592 aged 40-64 years [41.8%]; 24 589 female [51.2%]; 8260 Hispanic [17.2%], 5859 non-Hispanic Black [12.2%], and 29 584 non-Hispanic White [61.6%]) reported no history of cancer and 5091 individuals (1624 aged 40-64 years [37.7%]; 2927 female [57.5%]; 321 Hispanic [6.3%], 361 non-Hispanic Black [7.1%], and 4159 non-Hispanic White [81.7%]) reported a history of cancer. After adjustment for sociodemographic variables, cancer survivors were more likely to report taking antidepressants (adjusted odds ratio [aOR], 1.32; 95% CI, 1.18-1.49) and anxiolytics (aOR, 1.38; 95% CI, 1.23-1.54) compared with the general population. Among cancer survivors, non-Hispanic Black individuals had lower odds of taking antidepressants (aOR, 0.60; 95% CI, 0.39-0.91) and anxiolytics (aOR, 0.63; 95% CI, 0.42-0.94) compared with non-Hispanic White individuals. Cancer survivors on Medicare (aOR, 2.20; 95% CI, 1.39-3.50) or Medicaid (aOR, 1.83; 95% CI, 1.18-2.84) were more likely to take anxiolytics compared with privately insured individuals. Cancer type was also associated with medication use; respondents with a history of brain cancer were more likely to take antidepressants (aOR, 5.59; 95% CI, 1.79-17.46), and those with a history of pancreatic cancer were more likely to take antidepressants (aOR, 5.30; 95% CI, 1.64-17.18) and anxiolytics (aOR, 6.74; 95% CI, 2.11-21.55) compared with those with a history of breast cancer.
In this study, cancer survivors were significantly more likely to take medications for depression and anxiety compared with noncancer survivors, underscoring the importance of mental health in cancer. However, our findings suggested disparities associated with this, with non-Hispanic Black patients exhibiting decreased use.
抑郁症和焦虑症对癌症幸存者的影响尤为严重。社会人口统计学因素常常影响癌症护理的可及性；然而，这些因素是否与获得精神和行为健康状况的药物治疗相关尚不清楚。
评估癌症幸存者与美国普通人群相比抗抑郁药和抗焦虑药的使用情况，并确定社会人口统计学因素与药物使用之间的关联。
设计、背景和参与者：在这项横断面研究中，2024年1月对2016年至2018年美国国家健康访谈调查的数据进行了分析。具有全国代表性的基于人群的样本包括年龄在18至85岁、居住在美国且无癌症病史的美国国家健康访谈调查的受访者。
符合条件的受访者完成了成人功能和残疾补充问卷且结局数据无缺失。自我报告的抗抑郁药和抗焦虑药使用情况是主要结局，通过多变量逻辑回归分析进行估计，并对社会人口统计学因素进行了调整。
在53117名受访者中，48026人（21592人年龄在40 - 64岁[41.8%]；24589名女性[51.2%]；8260名西班牙裔[17.2%]，5859名非西班牙裔黑人[12.2%]，29584名非西班牙裔白人[61.6%]）报告无癌症病史，5091人（1624人年龄在40 - 64岁[37.7%]；2927名女性[57.5%]；321名西班牙裔[6.3%]，361名非西班牙裔黑人[7.1%]；4159名非西班牙裔白人[81.7%]）报告有癌症病史。在对社会人口统计学变量进行调整后，与普通人群相比，癌症幸存者更有可能报告服用抗抑郁药（调整后的优势比[aOR]，1.32；95%置信区间[CI]，1.18 - 1.49）和抗焦虑药（aOR，1.38；95% CI，1.23 - 1.54）。在癌症幸存者中，与非西班牙裔白人相比，非西班牙裔黑人服用抗抑郁药（aOR，0.60；95% CI，0.39 - 0.91）和抗焦虑药（aOR，0.63；95% CI，0.42 - 0.94）的几率较低。与私人保险的个体相比，参加医疗保险（aOR，2.20；95% CI，1.39 - 3.50）或医疗补助（aOR，1.83；95% CI，1.18 - 2.84）的癌症幸存者更有可能服用抗焦虑药。癌症类型也与药物使用相关；有脑癌病史的受访者更有可能服用抗抑郁药（aOR，5.59；95% CI，1.79 - 17.46），有胰腺癌病史的受访者与有乳腺癌病史的受访者相比，更有可能服用抗抑郁药（aOR，5.30；95% CI，1.64 - 17.18）和抗焦虑药（aOR，6.74；95% CI，2.11 - 21.55）。
在本研究中，与非癌症幸存者相比，癌症幸存者服用治疗抑郁症和焦虑症药物的可能性显著更高，这凸显了癌症患者心理健康的重要性。然而，我们的研究结果表明存在与此相关的差异，非西班牙裔黑人患者的药物使用减少。
