Association of Skin Cancer With Clinical Depression and Poor Mental Health Days: Cross-Sectional Analysis
Bibliographic record
Abstract
Background: Mental health is becoming increasingly recognized as an important part of overall health, especially for patients with cancer. However, the relationship between nonmelanoma skin cancer and mental health has not been widely studied. Objective: The aim of this study was to examine the association between nonmelanoma skin cancer diagnosis and 2 key mental health outcomes (ie, clinical depression and the number of poor mental health days). Methods: This study used the 2023 Behavioral Risk Factor Surveillance System, a nationally representative survey of adults in the United States, which included 312,317 participants. Nonmelanoma skin cancer diagnosis, depression, and self-reported mental health days were analyzed. Logistic regression was used to evaluate the association between nonmelanoma skin cancer and depression, whereas Poisson regression was used to model the number of poor mental health days, adjusting for age, sex, race and ethnicity, education, BMI, income, and major comorbid conditions (other cancers, heart disease, lung disease, and kidney disease). Results: Individuals with nonmelanoma skin cancer (5086/26,552, 19.15%) reported a lower overall rate of depression compared to those without nonmelanoma skin cancer (61,438/285,765, 21.50%; P<.001) but reported more poor mental health days on average (4.54, SD 8.37 d vs 3.20, SD 7.37 d; P<.001). After adjustment, nonmelanoma skin cancer diagnosis was not significantly associated with depression (adjusted odds ratio 1.01, 95% CI 0.98-1.05) and was associated with a slightly lower number of poor mental health days (adjusted rate ratio 0.94, 95% CI 0.91-0.97). Conclusions: Adults with nonmelanoma skin cancer experienced a meaningful mental health burden, and unadjusted analyses suggested greater day-to-day distress than among adults without nonmelanoma skin cancer. However, these differences were reduced and no longer significant for depression after adjusting for sociodemographic factors and comorbid chronic illnesses. These findings support the need for mental health screenings and support services in dermatologic and oncologic care.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".