# Trends in emotional distress among childhood, adolescent, and young adult (CAYA) cancer survivors: A decade-long study

## TL;DR

This study looked at emotional distress trends among childhood, adolescent, and young adult cancer survivors over a decade and found no significant changes.

## Contribution

The study provides a decade-long analysis of emotional distress trends in CAYA cancer survivors using U.S. national survey data.

## Key findings

- The proportion of individuals with mild/no distress increased until 2014 then decreased, but not significantly.
- Severe distress decreased by 7.36% annually after 2014, but also not statistically significant.
- No significant trends in emotional distress were found when stratified by demographics or mental health access.

## Abstract

We examined trends in emotional distress among survivors of childhood and adolescent and young adult (CAYA) cancers.

We analyzed the 2008–2018 National Health Interview Survey (NHIS) data among individuals (n = 6451) who were diagnosed with cancer between 0 and 39 years of age. Emotional distress was assessed using the validated Kessler 6-item scale. Respondents rated how often they felt nervous, hopeless, restless, or fidgety, so sad that nothing could cheer them up, that everything was an effort, and worthless in the past 30 days. Responses were scored and added to produce a range of 0–24. We classified emotional distress as mild/no (score of less <5), moderate (score between 5 and 12), or severe distress (≥ 13). Joinpoint regression estimated yearly increases/decreases in psychological distress using annual percent changes.

Overall, the proportion of individuals experiencing mild/no psychological distress increased by 1.68% annually between 2008 and 2014 and then decreased by 1.34% annually between 2014 and 2018, although not statistically significant. The proportion of individuals experiencing moderate distress decreased by 3.06% annually between 2008 and 2014 and then increased by 4.18% annually between 2014 and 2018, although not statistically significant. The proportion of individuals experiencing severe distress remained stable between 2008 and 2014 and then decreased by 7.36% annually between 2014 and 2018, although not statistically significant. No statistically significant trend in emotional distress was observed when stratified by patients’ demographics and access to mental health services.

We found that trends in emotional distress among survivors of CAYA cancers have not changed significantly over the 2008–2018 decade, overall and when stratified by gender, race/ethnicity, marital status, and visit to a mental health professional within the past year.

The online version contains supplementary material available at 10.1007/s00520-026-10580-7.