Depression Among Breast Cancer Survivors in Duhok, Iraq: A Quantitative Analysis Using HADS

Background and Aim: Breast cancer (BC) represents a significant warning to women’s health in Iraq, accounting for 40% of all new cancer cases in 2022. The depression challenge faced by breast cancer survivors (BCSs) results from the severe emotional influence of diagnosis and various management modalities. This study aims to examine the prevalence of depression among Iraqi BCS and the factors affecting it. Material and Methods: A cross-sectional study was conducted with a population of 161 BCSs aged 60 years and younger attending Azadi Hematology-Oncology Center in Duhok City, Iraq. The data were collected between December 2024 and February 2025, including demographics, clinical features, and the Hospital Anxiety and Depression Scale (HADS) to assess depression. The final score for HADS ranges from (0–21 points), in which a higher score indicates a higher level of depression. Results: Out of 161 breast cancer survivors participating in the study, the mean age was 41.97 ± 5.06 years, with the majority 118 (73.3%) aged between 40 and 60 years. Among the participants, 130 (80.7%) were married, and 127 (78.9%) were unemployed and housewives. Of the total population, 43 (26.7%) had depression, with a mean depression score of 7.67 ± 4.54 which was predominantly observed among unemployed, housewives and long-term survivors (>70 months). Conclusion: The findings highlight that depression is a significant challenge for breast cancer survivors in Iraq. Being unemployed and housewives with low family monthly incomes could be independent contributors to that issue. Survivors for a longer time were found to have higher scores on the HADS, and that group of subjects may need further attention from the healthcare providers. As breast cancer survival rates rise, psychosocial support programs, psychological screening, and consultations are required among healthcare systems to minimize the risk for developing depression.