Evaluating the impact of depression on self-reported quality of life measurements for patients with a history of cancer: A 2022 behavioral risk factor surveillance system questionnaire study.
Authors: Erin Patricia Ward, Divya Sood
Journal: Journal of Clinical Oncology (2024)

e23131 Background: Patients with cancer are known to have higher rates of depression than the general population. Depression is known to impact cancer-specific outcomes. We aimed to understand if a history of depression for patients with a history of cancer impacts self-reported quality of life measurements. Methods: We identified patients with a history of cancer and patients with a history of depression using the 2022 phone based Behavioral Risk Factor Surveillance System Questionnaire. The demographics and reported outcomes for several quality-of-life questions, including perceived emotional support, social isolation, cancer-related pain, memory, and ability to complete daily activities independently, were compared using a Chi-Square analysis. Results: Of the 441,339 patients over the age of 18 who completed the 2022 survey, 72,765 (16%) reported a history of cancer, and 90,489 (21%) reported a history of depression. Of those patients who reported a history of cancer 72,443 (99.6%) answered if they had ever been diagnosed with depression, and of these 14,987 (21%) reported a history of depression. Compared to patients with cancer alone, patients with a history of cancer and depression were younger (10% vs. 4% under the age of 45, p &lt; 0.001), less often married (45% vs.59%, p &lt; 0.001), more likely to be in the lowest income bracket (8% vs. 3%, p &lt; 0.001), more likely to be obese (36% vs. 26%, p &lt; 0.001), and more often active smokers (16% vs. 7%, p &lt; 0.001). Several quality-of-life questions were asked of the participants, although not everyone answered each question. Overall, among patients with cancer, patients with a history of depression were more likely to report &gt; 14 poor mental health or physical health days (35% vs. 6% and 34% vs. 14%, respectively, p &lt; 0.001) and more likely to report their general health as fair or poor (41% vs. 21%, p &lt; 0.001). Cancer patients with depression were less likely to report always having the social or emotional support that they need (33% vs. 55%, p &lt; 0.001) and more likely to report always or usually feeling socially isolated (17% vs. 5%, p &lt; 0.001). Cancer patients with depression were more likely to report pain associated with their cancer (16% vs. 7%, p &lt; 0.001) and five times as likely to report issues with making decisions and memory (31% vs. 6%, p &lt; 0.001). Finally, patients with depression were also more likely to report an inability to run errands alone (21% vs. 7%) and report difficulty getting dressed or bathing (12% vs. 4%, p &lt; 0.001). Conclusions: Among people with a history of cancer, those with a history of depression are more likely to report worse physical and mental health, report worse social and emotional support and report less independence in activities of daily living. Further work is needed to understand the complex interactions between depression and quality-of-life measures for cancer patients.