Linking cancer and mental health in men and women in a representative community sample

OBJECTIVE: In aging populations, a growing number of individuals are affected by cancer. However, the relevance of the disease for mental health is still controversial, especially after treatment. We drew from a representative community sample to explore the link of cancer with mental health assessing different dimensions and different periods of time.

METHODS: A cohort of 14,375 men and women (35-74 years) underwent medical assessments and was queried about cancer history, previous diagnoses of mental disorders, current mental distress symptoms, and current subjective health appraisal.

RESULTS: 1066 participants (7.4%) reported a diagnosis of cancer (survival time M = 9.79 (SD = 9.07) years). Most common were breast (24.3%), skin (20.9%), gynecological (13.8%), and prostate cancer (12.9%). Based on cut-off-scores of standardized self-report scales (PHQ-9, GAD-2), rates of depression (8.4%; 95%CI 6.90-10.30) and anxiety symptoms (7.8%; 95%CI 6.30-9.60) corresponded to those of participants without cancer. In men, cancer was related to a lifetime diagnosis of depression (OR = 2.15; 95%CI 1.25-3.64). At the time of assessment, cancer was associated with reduced subjective health in both sexes and with anxiety symptoms in men (OR = 2.43; 95%CI 1.13-4.98).

CONCLUSION: Findings indicate different relations of cancer in men and in women with different operationalizations of mental health. They underscore that a history of cancer is not universally linked to distress in the general population. The study points out that different ascertainments of the association of cancer and mental health might be traced back to different assessment strategies. It also notes potential targets for interventions to alleviate distress, e.g. by physical activity.