Little is known about cancer treatment patterns among the elderly as depression and cancer in this older population have not been well explored. This study seeks to fill a gap in the literature by using data from the Medicare Current Beneficiary Survey from years 2000–2005 to examine depression treatment patterns among elderly diagnosed with both cancer and depression. Depression treatments examined include antidepressants with and without psychotherapy. We found that of those with both cancer and depression, 57.7% reported antidepressant use only, 19.7% received psychotherapy with or without antidepressants, and 22.6% had no depression treatment. We found those with greater comorbidity, of a minority race, with lower levels of education, and living in rural areas were less likely to receive treatment for depression. These findings highlight the need to address disparities in the treatment of depression in the elderly population with cancer. 1. Introduction Cancer among the elderly has grown in prevalence, in 2007, 70% of those diagnosed with cancer in the United States were over 65 years of age, with 44% over the age of 75 [1]. Currently, among the US population there are 7 million people over the age of 65 living with cancer [2]. Projections from 2010 to 2030 estimate a 67% increase in cancer incidence among the US population that is 65 years and older, compared to an increase of only 11% in younger age groups [3]. Given the rapid increases in the number of elderly diagnosed with cancer, greater awareness, identification, evaluation, and treatment of depression this group has gained attention [4]. However, the elderly are not been specifically studied in current cancer studies. For example, in a metareview of 100 studies, the prevalence of depression among individuals of all ages with cancer was reported to have reached as high as 38%–58%, but these studies did not include the elderly [5]. Although depression has been recognized as detrimental to cancer prognosis, treatment, and related quality of life, not much is known about the treatment of depression among elderly with cancer. In one study that included both elderly and nonelderly, using data from community oncology practices in the US, individuals over age 60 were less likely to receive antidepressants compared to younger individuals [6]. Furthermore, it has been reported that the elderly with cancer are at risk of developing subthreshold forms of depression, meaning depression may go unrecognized and untreated [7]. In fact, it has been reported that overall, the elderly as a subgroup are
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