Abstract 4989: Sex disparity in cancer-related fatigue, depression, and impact on quality of life among cancer survivors: Insights from NHANES
Authors: Simo Du, Roha Memon, Shiwei Han, Yuqing Wang, Hasiya Yusuf, Jesus Anampa Mesias
Journal: Cancer Research (2025)

Abstract Introduction: Cancer-related fatigue (CRF) and depression are prevalent and debilitating conditions among cancer survivors, significantly impacting their quality of life (QoL). CRF affects up to 80% of patients during or after treatment, while depression affects 15-25%, often co-occurring with CRF. Female survivors are disproportionately affected due to hormonal, psychosocial, and societal factors. However, the extent of these disparities and their impact on QoL remain understudied. This study aims to address the gap by investigating sex differences in CRF and depression, with a focus on their effects on work and recreational activities as key surrogates for QoL Methods: We analyzed data from the 2015-2016 and 2017-2020 cycles of the National Health and Nutrition Examination Survey (NHANES), including 1, 555 cancer survivors representative of over 25 million U.S. survivors. Sampling weights were applied to account for NHANES' complex survey design. Three-step sequential logistic regression models were used to examine sex disparities in CRF and depression: (1) unadjusted, (2) adjusted for demographic variables (age, race), and (3) fully adjusted for demographics, socioeconomic factors (education, insurance), and comorbidities (e.g., hypertension, diabetes). CRF and depression were assessed using the validated Depression and Anxiety Screening Questionnaire (DPQ). Outcomes included vigorous or moderate work activities and recreational activities. Statistical significance was set at α = 0.05. Results: After adjusting for age, race, socioeconomic status (SES), and comorbidities, female cancer survivors had a 58% higher likelihood of experiencing depression compared to male survivors (OR = 1.58, 95% CI: 1.10-2.26, p = 0.014). Similarly, female survivors were 69% more likely to experience CRF than their male counterparts (OR = 1.69, 95% CI: 1.24-2.31, p &amp;lt; 0.001). CRF was not significantly associated with work-related activity limitations (OR = 1.17, 95% CI: 0.79-1.73, p = 0.431) but was strongly associated with reduced moderate recreational activities (OR = 1.83, 95% CI: 1.26-2.66, p = 0.002). Depression was also associated with reduced recreational activities (OR = 1.65, 95% CI: 1.05-2.58, p = 0.02). Conclusion: Female cancer survivors are disproportionately affected by higher rates of CRF and depression, with both conditions reducing engagement in recreational activities and adversely affecting QoL. These findings highlight the importance of targeted interventions to address sex disparities in CRF and depression, with the ultimate goal of improving QoL among cancer survivors. Citation Format: Simo Du, Roha Memon, Shiwei Han, Yuqing Wang, Hasiya Yusuf, Jesus Anampa Mesias. Sex disparity in cancer-related fatigue, depression, and impact on quality of life among cancer survivors: Insights from NHANES [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4989.