Abstract 825: Adverse childhood experiences and history of depression among cancer survivors
Authors: Babatunde Oluwole Adeyemi , Collucielli Vince , Jefferson Melanie S. , Adams Swann Arp , Halbert Chanita Hughes , Obeysekare Jessica , Clark Frank , Nagar Anusuiya , Osazuwa-Peters Nosayaba , Boakye Eric Adjei 
Published: March 2024

Abstract
Introduction: Adverse Childhood Experiences (ACEs) are stressful life events that are associated with an increased risk of depression. Depression is experienced by 25% of cancer survivors in the US. While previous studies have examined the associations between ACEs and depression in the general population, studies on cancer survivors are lacking. We aimed to examine the predictors of depression with a primary focus on ACEs among cancer survivors.
Methods: Using a cross-sectional data from the 2020 Behavioral Risk Factor Surveillance System for 19,241 cancer survivors aged 18 and above, we categorized ACEs based on severity. The ACE categories (zero, one, two-three, ≥four) included questions assessing exposure to eight types of ACEs before age 18 years. The outcome is self-reported history of depression diagnosis (yes/no). Weighted multivariable logistic regression models estimated odds of depression by ACEs as the primary variable and covariates were age, gender, smoking status, income, education, marital status, body mass index, health status and race.
Results: In this sample of cancer survivors, 41%, 22%, 21% and 16% reported having experienced zero, one, two-three, and &gt;4 ACEs respectively. Personal history of depression was reported by 21% of survey respondents. In the adjusted model, survivors with 1 ACE (aOR: 1.6, 95% CI. 1.2- 2.0), 2-3 ACEs (aOR: 1.7, 95% CI. 1.3- 2.1), or &gt;=4 ACES (aOR: 4.4, 95% CI. 3.4- 5.7) had higher odds of depression compared with those with zero ACEs. Additional notable predictors of higher odds of depression are younger age, 18-39 (aOR: 2.7, 95% CI. 1.8- 4.0), middle age, 40-64 (aOR: 1.6, 95% CI. 1.3- 1.9) compared with those aged 65 and older; females (aOR: 2.1, 95% CI. 1.7- 2.5) compared with males; obese respondents (aOR: 1.5, 95% CI. 1.2- 1.9) compared with respondents with normal body mass index; current smokers (aOR: 1.5, 95% CI. 1.2- 2.0) compared with respondents who never smoked; and poor or fair health status (aOR: 3.2, 95% CI. 2.6- 3.9) compared with respondents with excellent/good health status.
Conclusion: Adult cancer survivors who experience ACEs as children represent an important targeted prevention group to reduce risk of depression. Variation by age, obesity, female gender, current smoking status, and poor health associated factors that may reduce the risk of depression warrants additional studies regarding potential for identification of resilient factors; and this may inform future selective prevention strategies, as well as identify a pathway between ACE and depression among cancer survivors.
Citation Format: Oluwole Adeyemi Babatunde, Vince Collucielli, Melanie S. Jefferson, Swann Arp Adams, Chanita Hughes Halbert, Jessica Obeysekare, Frank Clark, Anusuiya Nagar, Nosayaba Osazuwa-Peters, Eric Adjei Boakye. Adverse childhood experiences and history of depression among cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 825.