Associations of stress and depressive symptoms with cancer in older Mexican Americans

Objectives: Cancer outcomes vary by ethnicity and socioeconomic status, particularly among the elderly. Although not well understood, there is increasing evidence that psychosocial issues, including depression, may be particularly influential among older minority groups. The objective of this study was to explore associations of stress and depressive symptoms with prevalent cancer in older Mexican Americans. Methods: Conditional logistic regression analyses were performed on baseline data from the Hispanic EPESE (collected in 1993, 1994) to explore associations of stress and depressive symptoms with prevalent cancer. Results: Higher education, income, and acculturation were associated with cancer. In general, people with more education and greater income, men, and those evidencing greater acculturation were more likely to have cancer. People with cancer had also experienced more adverse life events: specific discrete life events, especially losses, were found to be more important than total number of life events. There was evidence of a J curve in the relationship of depressive symptoms with cancer, particularly for women. The presence of between three and seven symptoms was inversely associated with cancer for women, while clinical depression was positively associated with the disease. In addition, depression was positively associated with cancer in men who felt hopeless. Conclusions: In the fastest growing segment of those aged 65 in the United States, Mexican Americans, our findings suggest that some psychosocial factors are associated with cancer and have implications for treatment. Consistent with other research, factors associated with cancer generally reflect greater assimilation. Further exploration of subclinical depression in this older group is needed.