Abstract P2-03-10: Functional Disability and Adverse Mental Health Outcomes among Breast Cancer Survivors: A US National Survey Study

Abstract Background: Breast cancer diagnosis and treatment can have a negative impact on patients’ mental health and well-being. Disability adds another layer of adverse effects to survivorship, and cancer survivors with disabilities may bear heavier burdens of mental health symptoms. However, little is known about the relationships between disability and adverse mental health outcomes among breast cancer survivors in the US. Methods: We analyzed data from the 2022 National Health Interview Survey that used multistage probability sampling to interview US adults. This study was restricted to adults with a breast cancer history. Any disability (yes/no) was defined by the Washington Group Composite Disability Indicator measuring the self-reported level of difficulty in 6 functional domains: vision, hearing, mobility, communication, cognition, and self-care. Ever having anxiety was per self-report (yes/no), and level of severity in the past 2 weeks was assessed using the 7-item Generalized Anxiety Disorder scale (none-minimal, mild, moderate, and severe). Participants self-reported ever having depression (yes/no), and level of severity in the past 2 weeks was assessed using the 8-item Patient Health Questionnaire depression scale (none-minimal, mild, moderate, and severe). We compared weighted proportions using Rao-Scott Chi-squared tests and calculated P-trends using the Cochran-Armitage test. Multivariable weighted logistic regression was used to estimate adjusted odds ratios (AOR). All statistical analyses accounted for complex design and survey weights. Results: The unweighted sample size was 644, representing a weighted sample of 4,234,520 US breast cancer survivors. The mean age was 68 years; 79.8% were White, followed by 9.7% Black, 6.3% Hispanic, and 3.6% Asian. Overall, 21.2% had any disability, and they were older than those without disabilities (73 vs. 67 years). Black survivors reported a higher proportion of having any disability than White survivors (27.3% [95% CI: 13.9-40.6%] vs. 21.8% [95% CI: 17.8-25.7%]). Of the total, 25.9% (95% CI: 21.8-30.1%) and 21.3% (95% CI: 17.5-25.1%) have ever experienced depression and anxiety disorder, respectively. Survivors with any disability reported a higher percentage of depression than those without (35.3% [95% CI: 25.3-45.2%] vs. 23.5% [19.0-27.9%], P=.023). The proportion of anxiety was higher among survivors with any disability than those without (32.3% [95% CI: 22.5-42.1%] vs. 18.3% [14.3-22.3%], P=.004). After controlling for demographic and socioeconomic factors, survivors with any disability had greater odds of depression than those without (AOR 1.90, 95% CI: 1.08-3.36). The odds of anxiety were much greater among survivors with any disability than those without (AOR 2.47, 95% CI: 1.35-4.50). In addition, compared with survivors without disabilities, those with any disability were more likely to experience mild (25.1% vs. 15.5%), moderate (20.3% vs. 4.1%) or severe (2.7% vs. 0.8%) depression (P-trend<.001). Similarly, survivors with any disability tended to experience mild (19.6% vs. 8.9%), moderate (8.4% vs. 3.4%), or severe (4.1% vs. 2.0%) anxiety than those without (P-trend<.001). Conclusions: In this US national sample of breast cancer survivors, 1 in 5 had any functional disability, 1 in 4 experienced depression, and 1 in 5 experienced anxiety. Survivors with any disability had a greater likelihood of lifetime depression or anxiety and an increased level of severity of recent mental health symptoms than those without. Early and routine screening for these symptoms in this population is needed. Oncology programs should identify unmet needs, provide appropriate supportive care or services for cancer-related disability, and improve mental health among breast cancer survivors, particularly those with functional disabilities. Citation Format: Jincong Freeman, Xinyi Li, Yong Gun Lee, Victoria Umutoni. Functional Disability and Adverse Mental Health Outcomes among Breast Cancer Survivors: A US National Survey Study [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P2-03-10.