Untreated depression common in minority women with cancer

A substantial number of low-income, ethnic minority women with breast or gynecologic cancer have untreated depression, researchers report in the May 1st issue of the Journal of Clinical Oncology.

“We hope that our study encourages routine screening for depression that will uncover depressed low-income women who would not be identified otherwise,” lead investigator Dr. Kathleen Ell told Reuters Health. Dr. Ell of the University of Southern California, Los Angeles and colleagues investigated depression, correlates of depression and receipt of depression care among 472 women receiving cancer care in a large urban public medical center.Nearly 80% of the women were Latina. The majority were Spanish speaking, foreign born, and were insured under Medi-Cal or limited state or local short-term assistance for specific cancer treatments. Twenty-four percent of the cohort met standard criteria for major depressive disorder, “a rate,” Dr. Ell continued, “more than double found in a recent study of middle and upper-class, predominantly white women.” “Most striking and of major concern,” she added, was that only 12% of depressed women were receiving antidepressant medication and only 5% were seeing a counselor or participating in a cancer support group.High rates of pain and anxiety, poorer functional status, and having arthritis correlated with higher rates of depression. Lack of family support also predicted higher rates of depression. Depression was not related to cancer care or treatment status. Depressed women were significantly more likely to report fears about cancer treatment and its side effects and to lack an adequate understanding of the treatment. They were also apt to be concerned about lost wages due to illness or medical appointment and about their ability to get all the prescribed medications.”Given that the population is low-income,” Dr. Ell concluded, “we speculated that depression might be associated with potential economic and health literacy barriers to cancer care and we found this to be strikingly the case.” (Source: J Clin Oncol 2005;23:3052-3060: Reuters Health: Oncolink: May 2005.)