Burden of depression among Canadian adults with cancer; results from a national survey

ABSTRACT

Objective

To assess the prevalence and association of depression among Canadian adults with cancer in a population-based context.

Methods

The Canadian Community Health Survey (CCHS) (2015–2016) was accessed and adult participants with cancer who completed the Personal Health Questionnaire (PHQ9) were included in the current analysis. Multivariable logistic regression was conducted to elucidate the factors associated with the development of depression. An additional multivariable logistic regression analysis was conducted to evaluate the association of depression with ever contemplating suicide (suicidal ideation).

Results

A total of 867 participants with cancer have completed PHQ9 were included in the current analysis (including 603 participants (69.6%) without depression (PHQ9 ≤ 4) and 264 participants (30.4%) with depression (PHQ9 > 4)). Moreover, 92 participants (10.6%) fulfill the criteria for moderate/severe depression (PHQ9 > 9). The following factors were associated with the presence of depression (PHQ9 > 4), female sex (OR for males versus females: 0.56; 95% CI: 0.34–0.93; P = 0.02); poor self-perceived health (OR for excellent health versus poor health: 0.12; 95% CI: 0.02–0.62; P = 0.01) and poor self-perceived mental health (OR for excellent mental health versus poor mental health: 0.02; 95% CI: <0.01–0.24; P < 0.01). Additional multivariable logistic regression analysis showed that depression (PHQ9 > 4) was associated with a higher probability of suicidal ideation (OR for no depression versus depression: 0.43; 95% CI: 0.21–0.91; P = 0.02).

Conclusions

Depression seems to be an underdiagnosed and possibly undertreated comorbid condition among Canadian adults with cancer.

KEYWORDS:

• Cancer
• depression
• suicide
• outcomes

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Author contributions

Omar Abdel-Rahman wrote the manuscript, and the other authors reviewed the manuscript and all authors approved it finally.

Data availability statement

This work is based on CCHS which is a Canadian national population-based survey. These dataset can only be accessed after getting relevant approvals from Statistics Canada: https://www.statcan.gc.ca/eng/survey/household/3226

Ethical approval statement

Because this study was based on publicly available, open-license anonymized dataset, ethical approval was not required. CCHS datasets were shared by StatCan to eligible Canadian Institutes through Data Liberation Initiative (DLI): https://www.statcan.gc.ca/eng/dli/dli

The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments

Patient consent statement

All included CCHS participants have signed informed consent as dictated by Statistics Canada policies.

Additional information

Funding

This paper was not funded.