Age-specific prevalence and determinants of depression in long-term breast cancer survivors compared to female population controls

Daniela Doege*, Melissa S.Y. Thong, Lena Koch-Gallenkamp, Lina Jansen, Heike Bertram, Andrea Eberle, Bernd Holleczek, Ron Pritzkuleit, Annika Waldmann, Sylke R. Zeissig, Hermann Brenner, Volker Arndt

*Corresponding author for this work


Background: Depression is more prevalent in breast cancer (BC) survivors than in the general population. However, little is known about depression in long-term survivors. Study objectives were: (1) to compare the age-specific prevalence of depressive symptoms (a) in BC survivors vs female population controls, (b) in disease-free BC survivors vs BC survivors with self-reported recurrence vs controls, and (2) to explore determinants of depression in BC survivors. Methods: About 3010 BC survivors (stage I-III, 5-16 years post-diagnosis), and 1005 population controls were recruited in German multi-regional population-based studies. Depression was assessed by the Geriatric Depression Scale-15. Prevalence of mild/severe and severe depression only were estimated via logistic regression, controlling for age and education. Multinomial logistic regression was used to explore determinants of mild and severe depression. Results: Compared with population controls, BC survivors were more likely to report mild/severe depression (30.4% vs 23.8%, p =.0003), adjusted for age and education. At all age groups <80 years, prevalence of both mild/severe and severe depression only was significantly higher in BC survivors, while BC survivors ≥80 years reported severe depression less frequently than controls. BC survivors with recurrence reported significantly higher prevalence of mild/severe depression than disease-free survivors and controls, but prevalence in disease-free survivors and controls was comparable. Age, income, living independently, recurrence, and BMI were significant determinants of mild depression in BC survivors. Age, education, employment, income, recurrence, and BMI were significant determinants of severe depression. Conclusions: Long-term BC survivors <80 years report significantly higher prevalence of depressive symptoms than controls, which might be explained by recurrence and individual factors. The findings suggest that depression in BC survivors is common, and even more after BC recurrence. Clinicians should routinize screening and normalize referral to psychological care.

Original languageEnglish
JournalCancer Medicine
Issue number22
Pages (from-to)8713-8721
Number of pages9
Publication statusPublished - 01.11.2020

Research Areas and Centers

  • Research Area: Center for Population Medicine and Public Health (ZBV)

DFG Research Classification Scheme

  • 205-14 Haematology, Oncology
  • 205-02 Public Health, Health Services Research and Social Medicine


Dive into the research topics of 'Age-specific prevalence and determinants of depression in long-term breast cancer survivors compared to female population controls'. Together they form a unique fingerprint.

Cite this