Abstract B121: Racial disparities in the association between adverse childhood experiences and history of self-reported depression among cancer survivors
Authors: Babatunde Oluwole A. , Jefferson Melanie S. , Adams Swann A. , Halbert Chanita Hughes , Clark Frank , Nagar Anusuiya , Osazuwa-Peters Nosayaba , Boakye Eric A. 
Published: December 2023

Abstract
Introduction. Depression is experienced by 25% of cancer survivors in the United States, and there are racial differences in how adverse childhood experiences (ACEs) affect depression. While previous studies have examined association between ACEs and depression in general population, studies focusing on cancer survivors are lacking. The purpose of this study was to assess the association between ACEs and history of self-reported depression among cancer survivors in different race groups. Methods. This study was a cross-sectional analysis of the 2020 Behavioral Risk Factor Surveillance System among 19,241 cancer survivors. The ACE category (zero, one, two-three, ≥four) included questions assessing exposure to eight types of adverse childhood experiences: three types of abuse (physical, emotional, and sexual) and five types of household challenges (household member substance misuse, incarceration, mental illness, parental divorce, or witnessing intimate partner violence) before age 18 years. The outcome is self-reported history of depression (yes/no). Three weighted multivariable logistic regression models were used to examine the association between ACE and depression for each race group: Non-Hispanic White (NHW), Non-Hispanic Black (NHB) and Hispanics, adjusting for age, sex, smoking status, income, education, marital status, body mass index, health status. Results. In this sample of cancer survivors, 41%, 22%, 21% and 16% reported having experienced zero, one, two-three, and &gt;=4 ACEs respectively. Majority of survivors were NHW (82.5%) while 6.2%, 6.4% and 4.9% were NHB, Hispanics, and Others respectively. Personal history of depression was reported by 21% of survey respondents. Among survivors experiencing &gt;=4 ACEs, depression was reported by 46.9 % of NHW, 55.2% of NHB and 50.6% of Hispanics. In the adjusted models, among NHW survivors with 1 ACE (aOR: 1.7, 95% CI. 1.3– 2.2), 2-3 ACEs (aOR: 1.9, 95% CI. 1.5– 2.4), or &gt;=4 ACES (aOR: 4.2, 95% CI. 3.3– 5.5) had higher odds of depression compared with those with zero ACEs. Among NHB, survivors with &gt;=4 ACEs had higher odds of depression (aOR: 2.5, 95% CI. 1.2– 5.0) compared with those with zero ACEs; no significant difference was observed for survivors with 1 or 2-3 ACEs. Similarly, among Hispanics, survivors with &gt;=4 ACEs had higher odds of depression (aOR: 11.3, 95% CI. 5.4– 23.8) compared with those with zero ACEs whiles no significant difference was observed for survivors with 1 or 2-3 ACEs. Conclusion. Persons with ACEs may represent an important targeted prevention group to reduce risk of depression among cancer survivors. While there is a relationship between all categories of ACE and depression among NHW cancer survivors, only those with &gt;=4 ACEs had association with depression among NHB and Hispanics. Potential variation by race warrants additional studies regarding potential for selective prevention and identification of resilient, cultural, and healthcare access factors.
Citation Format: Oluwole A. Babatunde, Melanie S. Jefferson, Swann A. Adams, Chanita Hughes Halbert, Frank Clark, Anusuiya Nagar, Nosayaba Osazuwa-Peters, Eric A. Boakye. Racial disparities in the association between adverse childhood experiences and history of self-reported depression among cancer survivors [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B121.