Are Depressive Symptoms Associated with Cancer Screening and Cancer Stage at Diagnosis among Postmenopausal Women? The Women's Health Initiative Observational Cohort

Abstract

Background: Women with depressive symptoms may use preventive services less frequently and experience poorer health outcomes. We investigated the association of depressive symptoms with breast and colorectal cancer screening rates and stage of cancer among a cohort of postmenopausal women. Methods: In The Women's Health Initiative Observational Study, 93,676 women were followed on average for 7.6 years. Depressive symptoms were measured at baseline and at 3 years using the 6-item scale from the Center for Epidemiological Studies Depression scale (CES-D). We calculated a cancer screening rate expressed as a proportion of the years that women were current with recommended cancer screening over the number of follow-up visits in the study. Breast and colorectal cancers were staged based on Surveillance, Epidemiology and End Results (SEER) classification. Results: At baseline, 15.8% (12,621) women were positive for depressive symptoms, and 6.9% (4,777) were positive at both baseline screening and at 3 years. The overall average screening rate was 71% for breast cancer and 53% for colorectal cancer. The breast cancer screening rate was 1.5% (CI 0.9%-2.0%) lower among women who reported depressive symptoms at baseline than among those who did not. Depressive symptoms were not a predictor for colorectal cancer screening. Stage of breast and colorectal cancer was not found to be associated with depressive symptoms after adjusting for covariates. Conclusions: Among a healthy and self-motivated cohort of women, self-reported depressive symptoms were associated with lower rates of screening mammography but not with colorectal cancer screening.

Depression and Anxiety Diagnoses Are Not Associated with Delayed Resolution of Abnormal Mammograms and Pap Tests Among Vulnerable Women

“…For example, a delay of several months for an abnormal mammogram may be clinically more significant than several months of delayed resolution for abnormal Pap tests. However, our results contrast from studies of cancer screening tests reporting depression being associated with less screening mammography, 2,25 but not with fewer Pap tests. Prior research found conflicting effects between the relationship of cancer screening behavior and depression.…”

Increased Mortality Risk among the Visually Impaired: The Roles of Mental Well-Being and Preventive Care Practices

“…Higher levels of depressive symptomatology were found to be associated with reduced rates of breast cancer screening behaviors in women. [44][45][46][47] On the other hand, similar associations were not found between cervical cancer screening and depressive symptoms, 45 nor was a direct association found for colorectal cancer in women and men. 48 When the analysis was performed by restricting to those participants with ''No VI'' and ''Some VI'' by excluding the blind participants, the direct effect of VI on all-cause mortality had the same directionality and was weakened; HR decreased from HR ¼ [1.11, 1.74], P < 0.05.…”

Psychosocial Stress as a Risk Factor for Sepsis

“…(54) However, while the symptom windows for CES-D and PSS are relatively short, gauging symptoms within the prior week or month, numerous studies have linked these measures with long-term health outcomes. (55–58) Repetition of the study with more comprehensive or robust assessment tools and periodic reassessments may alter the observations. The REGARDS study is currently re-examining all members of the cohort, and in a future effort it may be possible to determine if interval changes in reported depressive symptoms may be associated with sepsis incidence.…”