Caregiving responsibility and psychological distress among community-dwelling cancer survivors in the United States

Abstract Purpose. There are more than 18 million cancer survivors in the US, with a projected increase of 24.4% over the next decade. Currently, little is known about the relationship between a cancer survivor’s caregiving responsibility and psychological distress. This study examines whether cancer-survivor caregivers experience increased psychological distress compared to cancer survivors without caregiving responsibilities. Methods. Data were drawn from the National Cancer Institute’s Health Information National Trends Survey (HINTS5, Cycles 1 through 4, 2017–2020). The analytical sample includes 2,579 US cancer survivors (aged ≥65 years=50.5%, females=57.1%). Caregiving responsibility was self-reported, and psychological distress was assessed through the Patient Health Questionnaire-4 (PHQ-4). Accounting for the complex design features of HINTS and jackknife replicate weights, a multivariable multinomial logistic regression model was fit to compute adjusted odds ratios (aORs) and their associated 95% confidence intervals (CIs). Results. About 19.1% (n=377) of cancer survivors self-reported caregiving responsibilities. Overall, 19.3% (n=438) of cancer survivors had mild, and 10.9% (n=252) had moderate to severe psychological distress. Compared to cancer survivors with no caregiving responsibilities, caregivers had more than two-fold higher odds of experiencing mild (aOR=2.25; 95% CI: 1.17, 4.29), and moderate to severe (aOR=2.18; 95% CI: 1.07, 4.46) psychological distress. Conclusions. Our findings indicate that caregiving responsibilities among cancer survivors have a substantial adverse impact on their mental and emotional wellbeing. Implications for Cancer Survivors.Cancer-survivor caregivers are a distinct subgroup that navigates both survivorship and caregiving burdens at the same time. There is a need to identify and develop tailored interventions, programs, and resources for this vulnerable group of caregivers.