Risk Factors for Late-Onset Depression in Long-Term Cancer Survivors

A recent study published in JAMA Network Open highlights socioeconomic vulnerability and multiple medical comorbidities as significant risk factors for late-onset depression among long-term cancer survivors aged 66 and older. The study analyzed data from 53,769 five-year survivors of breast, prostate, or colorectal cancer using 2022 linked Surveillance, Epidemiology, and End Results and Medicare databases. Results showed that breast cancer survivors had the highest five-year risk for late-onset depression at 13.3%, followed by colorectal at 11.8% and prostate cancer survivors at 8.7%. Age influenced depression risk differently among cancer types; for example, prostate cancer survivors aged 90+ showed a notably higher hazard compared to younger survivors, an effect not observed among colorectal cancer survivors of the same age group. Socioeconomic status, measured by Medicare-Medicaid dual eligibility, consistently correlated with greater depression risk. Clinical factors such as anxiety and higher comorbidity burden also significantly increased late-onset depression risk across all cancer survivor groups. In prostate cancer survivors, radiotherapy combined with or without androgen deprivation therapy further elevated depression risk. These findings suggest integrating these identified risk factors into survivorship care could optimize preventive strategies and address disparities in depression screening and treatment, particularly as cancer patients transition from active surveillance to preventive care. This research underscores the importance of a multidisciplinary approach that factors in social determinants of health and comorbidity management in long-term cancer survivorship planning.