Anxiety and depression in colorectal cancer survivors: Are there differences by sexual orientation

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Department of Population and Quantitative Health Sciences

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Digestive System Diseases | Epidemiology | Gender and Sexuality | Health Services Research | Neoplasms | Oncology | Psychiatry and Psychology


OBJECTIVE: To examine sexual minority compared to heterosexual survivors' health-related anxiety, anxiety, and depression.

METHODS: Four hundred and eighty eligible survivors participated in a telephone survey, which measured their anxiety and depression. These survivors were diagnosed with stage I, II, or III colorectal cancer an average of three years prior to the survey and were recruited from four cancer registries. As explanatory factors, we considered individual, social and contextual characteristics, prior psychological factors, psychological responses to cancer, and characteristics of cancer and its treatments. Using forward selection with generalized linear models or logistic regression models, we identified significant correlates for each outcome.

RESULTS: Prior to adjusting for covariates, depression was similar for all survivors, while sexual minority survivors had worse health-related anxiety and anxiety compared to heterosexual survivors. After adjustment, these differences were no longer statistically significant. Individual, social and contextual characteristics, characteristics of cancer, and psychological responses to cancer explained 44% of the variance in anxiety and 60% of the variance in depression.

CONCLUSION: There are modifiable factors associated with health-related and generalized anxiety as well as depression that can be changed to improve cancer survivorship among diverse survivors.


anxiety, cancer survivorship, colorectal neoplasms, depression, psychological distress, sexual and gender minorities

DOI of Published Version



Boehmer U, Ozonoff A, Winter M, Berklein F, Potter J, Ceballos RM, Clark MA. Anxiety and depression in colorectal cancer survivors: Are there differences by sexual orientation? Psychooncology. 2022 Mar;31(3):521-531. doi: 10.1002/pon.5837. Epub 2021 Oct 26. PMID: 34672050. Link to article on publisher's site

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