The role of social position in anxiety and depressive symptoms among Danish cancer survivors

Figures & data

Figure 1. Inclusions and exclusions in the study population.

Figure 2. Distribution of scores for symptoms of anxiety and depression by length of education among cancer survivors living in Denmark 2 years after diagnosis, complete cases (n = 1667).

Table I. Basic characteristics of cancer survivors living in Denmark about 2 years after diagnosis, complete cases (n = 1667).

	Total N (%)^a	Education N (%)^a
		Basic	Medium	Higher	p (χ^2)
Total	1667 (100)	330 (100)	560 (100)	777 (100)
Sex  Male  Female	735 (44) 932 (56)	148 (45) 182 (55)	301 (54) 259 (46)	286 (37) 491 (63)	< 0.0001
Age (years)  19–39  40–49  50–59  60–69  70–79  80–96	59 (4) 137 (8) 366 (22) 642 (39) 363 (22) 100 (6)	4 (1) 11 (3) 50 (15) 141 (43) 92 (28) 32 (10)	16 (3) 44 (8) 108 (19) 219 (39) 135 (24) 38 (7)	39 (5) 82 (11) 208 (27) 282 (36) 136 (18) 30 (4)	< 0.0001
Cohabitation status  Married/cohabiting  Widow/widower  Single	1295 (78) 155 (9) 217 (13)	238 (72) 55 (17) 37 (11)	448 (80) 50 (9) 62 (11)	609 (78) 50 (6) 118 (15)	< 0.0001
Children  Not living at home  Living at home  Both  No children	1228 (74) 169 (10) 102 (6) 168 (10)	277 (84) 8 (2) 15 (5) 30 (9)	422 (75) 49 (9) 27 (5) 62 (11)	529 (68) 112 (14) 60 (8) 76 (10)	< 0.0001
Cancer site  Smoking-related  Colorectal  Breast  Prostate  Other	220 (13) 248 (15) 497 (30) 253 (15) 449 (27)	50 (15) 62 (19) 89 (27) 52 (15) 77 (23)	71 (13) 91 (16) 143 (26) 95 (17) 160 (29)	99 (13) 95 (12) 265 (34) 106 (14) 212 (27)	0.004
Surgery  Yes  No	1352 (81) 315 (19)	266 (81) 64 (19)	455 (81) 105 (19)	631 (81) 146 (18)	0.97
Radiation  Yes  No	474 (28) 1193 (72)	94 (28) 236 (72)	148 (26) 412 (74)	232 (30) 545 (70)	0.39
Chemotherapy  Yes  No	579 (35) 1088 (65)	102 (31) 228 (69)	184 (33) 376 (67)	293 (38) 484 (62)	0.05
Somatic comorbidity  No disorders  1 disorder  ≥ 2 disorders	1101 (66) 444 (27) 122 (7)	212 (64) 90 (27) 28 (8)	363 (65) 145 (26) 52 (9)	526 (68) 209 (27) 42 (5)	0.08
Mental disorder  Yes  No	129 (8) 1538 (92)	32 (10) 298 (90)	39 (7) 521 (93)	58 (7) 719 (93)	0.31

^aSome percentages do not sum up to 100 because of rounding.

Table II. Mean difference estimates (B) from general linear models of anxiety symptoms among cancer survivors living in Denmark about 2 years after diagnosis (n = 1667).

	Model 1^a			Model 2^b			Model 3^c
	B	95% CI	p^d	B	95% CI	p^d	B	95% CI	p^d
Education  Basic  Medium  Higher	0 0.36 0.26	– −0.12; 0.85 −0.25; 0.78	0.34	0 0.26 0.01	– −0.48; 0.50 −0.25; 0.76	0.43	0 0.41 0.19	– −0.07; 0.88 −0.27; 0.65	0.23
Sex  Male  Female				0 1.09	– 0.71; 1.46	< 0.0001	0 1.38	– 0.92; 1.85	< 0.0001
Age per year				−0.04	−0.07; −0.02	< 0.0001	−0.04	−0.06; −0.01	0.001
Cohabitation status  Married/cohabiting  Widow/widower  Single				0 0.18 0.53	– −0.47; 0.84 −0.03; 1.09	0.17	0 −0.01 0.22	– −0.63; 0.61 −0.31; 0.75	0.70
Children  Not living at home  Living at home  Both  No children				0 −0.19 0.41 −0.47	– −0.91; 0.53 −0.37; 1.20 −1.12; 0.17	0.27	0 −0.05 0.42 −0.21	– −0.73; 0.63 −0.33; 1.17 −0.82; 0.40	0.56
Cancer site  Smoking-related  Colorectal  Breast  Prostate  Other							1.11 0 −0.79 −0.24 −0.18	0.45; 1.76 – −1.41; −0.16 −0.93; 0.46 −0.76; 0.40	< 0.0001
Surgery  Yes  No							0.30 0	−0.19; 0.78 –	0.23
Radiation  Yes  No							0.04 0	−0.38; 0.45 –	0.86
Chemotherapy  Yes  No							0.57 0	0.17; 0.98 –	0.006
Somatic comorbidity  No disorders  1 disorder  ≥ 2 disorders							0 0.97 1.25	– 0.58; 1.36 0.60; 1.91	< 0.0001
Mental disorder  Yes  No							3.75 0	3.12; 4.38 –	< 0.0001

^aUnadjusted association between education and anxiety symptom scores; ^bInclusion of sex, age, cohabitation status, and children; ^cFurther inclusion of cancer form, surgery, radiation, chemotherapy, somatic comorbidity and mental disorder; ^dFor association with anxiety symptoms.

Table III. Mean difference estimates (B) from general linear models of depressive symptoms among cancer survivors living in Denmark about 2 years after diagnosis (n = 1667).

	Model 1^a			Model 2^b			Model 3^c
	B	95% CI	p^d	B	95% CI	p^d	B	95% CI	p^d
Education  Basic  Medium  Higher	0 0.19 −0.18	– −0.25; 0.63 −0.59; 0.24	0.13	0 0.20 −0.25	– −0.25; 0.64 −0.68; 0.18	0.05	0 0.34 −0.11	– −0.07; 0.75 −0.50; 0.29	0.03
Sex  Male  Female				0 0.32	– −0.02; 0.65	0.06	0 0.77	– 0.37; 1.17	0.0002
Age per year Quadratic age per year				−0.09 0.001	−0.19; 0.02 −0.0001; 0.002	0.10 0.08	−0.11 0.001	−0.20; −0.01 0.0002; 0.002	0.03 0.02
Cohabitation status  Married/cohabiting  Widow/widower  Single				0 −0.29 0.64	– −0.88; 0.30 0.14; 1.13	0.02	0 −0.45 0.33	– −1.00; 0.09 −0.12; 0.79	0.07
Children  Not living at home  Living at home  Both  No children				0 0.13 0.49 −0.01	– −0.53; 0.78 −0.21; 1.19 −0.58; 0.57	0.59	0 0.17 0.45 0.22	– −0.43; 0.78 −0.20; 1.09 −0.31; 0.75	0.52
Cancer site  Smoking-related  Colorectal  Breast  Prostate  Other							0.93 0 −0.67 0.20 −0.35	0.37; 1.49 – −1.20; −0.13 −0.40; 0.80 −0.84; 0.15	< 0.0001
Surgery  Yes  No							−0.22 0	−0.63; 0.20 –	0.31
Radiation  Yes  No							−0.08 0	−0.43; 0.28 –	0.66
Chemotherapy  Yes  No							0.85 0	0.50; 1.20 –	< 0.0001
Somatic comorbidity  No disorders  1 disorder  ≥ 2 disorders							0 1.22 1.57	– 0.88; 1.55 1.01; 2.13	< 0.0001
Mental disorder  Yes  No							3.46 0	2.92; 4.00 –	< 0.0001

^aUnadjusted association between education and depressive symptoms; ^bInclusion of sex, age, cohabitation status and children; ^cFurther inclusion of cancer site, surgery, radiation, chemotherapy, somatic comorbidity and mental disorder; ^dFor association with depressive symptoms.

Table IV. Basic characteristics distributed by level of participation in survey (n = 3298).

	Complete cases, n(%)^a	Missing covariates, n(%)^a	p^b	Missing key variables, n(%)^a	p^b	Non-responders in 2012, n(%)^a	p^b
Total	1667 (100)	459 (100)		442 (100)		730 (100)
Education  Basic  Medium  Higher  Unknown  Missing	330 (20) 560 (34) 777 (47) 0 (0) 0	136 (30) 162 (35) 161 (35) 0 (0) 0	< 0.0001	177 (41) 128 (30) 87 (20) 37 (9) 13	< 0.0001	174 (26) 230 (35) 245 (37) 15 (2) 66	< 0.0001
Sex  Male  Female	735 (44) 932 (56)	219 (48) 240 (52)	0.16	214 (48) 228 (52)	0.10	349 (48) 381 (52)	0.09
Age (years)  19–39  40–49  50–59  60–69  70–79  80–96	59 (4) 137 (8) 366 (22) 642 (39) 363 (22) 100 (6)	9 (2) 42 (9) 75 (16) 183 (40) 106 (23) 44 (10)	0.007	6 (1) 17 (4) 40 (9) 126 (29) 143 (32) 110 (25)	< 0.0001	39 (5) 64 (9) 136 (19) 218 (30) 170 (23) 103 (14)	< 0.0001
Cohabitation status  Married/cohabiting  Widow/widowed  Single  Missing	1295 (78) 155 (9) 217 (13) 0	317 (77) 54 (13) 42 (10) 46	0.03	284 (69) 69 (17) 61 (15) 28	< 0.0001	476 (70) 85 (13) 117 (17) 52	0.001
Children  Not living at home  Living at home  Both  No children  Missing	1228 (74) 169 (10) 102 (6) 168 (10) 0	303 (76) 39 (10) 24 (6) 34 (9) 59	0.79	330 (81) 18 (4) 8 (2) 51 (13) 35	< 0.0001	466 (70) 77 (11) 50 (7) 77 (11) 60	0.24
Cancer site  Smoking-related  Colorectal  Breast  Prostate  Other  Missing	220 (13) 248 (15) 497 (30) 253 (15) 449 (27) 0	59 (13) 55 (12) 126 (27) 102 (22) 117 (25) 0	0.008	63 (14) 68 (15) 104 (24) 93 (21) 114 (26) 0	0.01	114 (16) 117 (16) 156 (21) 110 (15) 231 (32) 2	0.001
Surgery  Yes  No  Missing	1352 (81) 315 (19) 0	293 (81) 67 (19) 99	0.90	273 (68) 126 (32) 43	< 0.0001	494 (74) 173 (26) 63	0.0002
Radiation  Yes  No  Missing	474 (28) 1193 (72) 0	97 (35) 177 (65) 185	0.02	104 (28) 265 (72) 73	0.92	176 (27) 465 (73) 89	0.64
Chemotherapy  Yes  No  Missing	579 (35) 1088 (65) 0	142 (45) 173 (55) 144	0.001	109 (28) 275 (72) 58	0.02	235 (36) 418 (64) 77	0.57
Somatic comorbidity  No disorders  1 disorder  ≥ 2 disorders  Missing	1101 (66) 444 (27) 122 (7) 0	163 (58) 89 (32) 27 (10) 180	0.04	186 (55) 107 (32) 43 (13) 106	0.0001	– – – –
Mental disorder  Yes  No  Missing	129 (8) 1538 (92) 0	20 (7) 259 (93) 180	0.74	19 (6) 317 (94) 106	0.18	– – –

^aSome percentages do not sum up to 100 because of rounding; ^bFor χ²-test of difference with the population included for multiple regression analyses. Missing values are not included in test.