Association of mental health treatment receipt with cancer screening among US adults with a history of anxiety or depression

Abstract

Background

Low participation in cancer screening contributes to a disproportionate burden of cancer morbidity and mortality among adults with mental health (MH) disorders like depression and anxiety. It is unknown whether MH treatment affects screening participation in this population.

Methods

Using the 2019 and 2021 National Health Interview Survey, data from screening-eligible respondents with a history of depression or anxiety were analyzed. Dependent variables include up-to-date screening for breast (BC), cervical (CVC), and colorectal cancer (CRC). Exposures of interest included past year receipt of any MH treatment and delayed or nonreceipt of counseling because of cost. Multivariable logistic regression was used to model associations between MH treatment and screening, controlling for sociodemographic and health care access characteristics.

Results

The prevalence of up-to-date screening was lower for those who did not receive MH treatment than those who did among respondents reporting regular feelings of depression or anxiety (adjusted prevalence ratio [aPR] = 0.83; 95% CI, 0.76–0.91 for BC; aPR = 0.83; 95% CI, 0.77–0.88 for CVC; aPR = 0.78; 95% CI, 0.73–0.84 for CRC) or ever being diagnosed with depression or anxiety (aPR = 0.86; 95% CI, 0.81–0.91 for BC; aPR = 0.87; 95% CI, 0.83–0.91 for CVC; aPR = 0.84; 95% CI, 0.80–0.88 for CRC). BC screening was lower for those who reported delayed or nonreceipt of therapy because of cost than those who did not (aPR = 0.88; 95% CI, 0.78–0.99 among adults with regular feelings of depression or anxiety; aPR = 0.91; 95% CI, 0.83–0.99 among adults ever diagnosed).

Conclusions

MH treatment is associated with increased screening among adults with a history of depression or anxiety. Enhancing MH treatment receipt could reduce the cancer burden in this population.