Self-reported depression in cancer survivors versus the general population: a population-based propensity score-matching analysis

  • Su Jung Lee
  • Kathleen B. CartmellEmail author



The purpose of the study was to evaluate health-related quality of life (HRQoL) and depression in community-dwelling cancer survivors using structured questionnaires and propensity score matching (PSM).


Subjects (age ≥ 30 years) who participated in the Sixth Korean National Health and Nutritional Exam Survey completed the EuroQoL5 Dimensions (EQ-5D) and Patient Health Questionnaire (PHQ-9). For the analysis, participants were divided into a cancer survivor group and a group consisting of the general cancer-free population. We compared PHQ-9 and EQ-5D Utility Index scores between the two groups, while controlling for underlying baseline demographic and clinical differences between groups using PSM. Additionally, we divided cancer survivors into two group (< 5 vs. ≥ 5 years since cancer diagnosis), and we evaluated whether the cancer prevalence period was associated with the EQ-5D Utility Index score.


Of all 4124 subjects, 208 cancer survivors were matched with 624 controls using PSM. PHQ-9 and EQ-5D scores in cancer survivors were not different from the general population. In unadjusted subgroup analyses, PHQ-9 scores and EQ-5D proportion of subjects with anxiety/depression (23.3% vs. 7.6%) were higher in cancer survivors with < 5 years since cancer diagnosis compared to those with ≥ 5 years. In multivariate analyses, predictors of depression in cancer survivors included household income and employment status, and predictors of HRQoL-included household income and subjective perceived health status. Period since the cancer diagnosis was not a predictor of either depression or HRQoL.


Depression and HRQoL in cancer survivors were similar to that experienced by the general population, and household income, perceived subjective health status and employment status were the main factors affecting depression and HRQoL in cancer survivors.


Neoplasm Depression Health-related quality of life Cancer survivorship Cross-sectional survey 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the Ethical Standards of the Institutional and/or National Research Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was conducted solely using a de-identified research dataset, with approval of exemption from review by the Institutional Review Board Ethics Committee of the Chuncheon Sacred Heart Hospital (IRB No. 2018-05-004), who exempted this study because we received all the data anonymized by the Korea Center for Disease Control.

Informed consent

Informed consent was obtained from all the participant before the KNHANES study began.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Chuncheon Sacred Heart Hospital Department of NursingHallym University CollegeChuncheon-siRepublic of Korea
  2. 2.Clemson University Department of Public Health SciencesClemsonUSA

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