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Scientific Oral Presentation

Care Equity, Quality, and Safety

Depression Prevalence and Utilization of Mental Health Services by Underserved Head and Neck Cancer Patients

Tuesday, October 20, 2026
8:24 AM - 8:30 AM PT
Location: 406A

    Presenting Author(s)

  • AS

    Ashley Stone, MD

    Resident Physician
    University of California - San Francisco
    San Francisco, California, United States

  • NA

    Nour Mary Aissaoui, MS

    Medical Student
    University of California, San Francisco, United States

    • Senior Author(s)

  • Mary Xu, MD

    Head and Neck Surgeon
    UCSF
    San Francisco, California, United States

Introduction: Depression is prevalent in patients with head and neck cancer and may worsen engagement with care. We examined the burden of depression and its association with clinical and demographic factors among head and neck cancer (HNC) patients treated at a safety-net hospital.

Methods: A retrospective cohort study of 128 patients with HNC at an underserved urban safety-net tertiary academic center between Aug 2019 – July 2024 was conducted. Demographics and indicators of depression and mental health care were extracted. Outcomes included depressive disorder diagnosis, antidepressant use, and referrals to mental health services. Logistic regression analysis was utilized to assess associations between depression and patient factors. Kaplan-Meier survival curves were generated and compared by the log-rank test to explore differences in 5-year survival among patients with and without depression.

Results: 34 (27%) had depression before HNC, 9 (7%) after HNC, and 85 (66%) had no depression. In a univariate model, there were significant associations between depression and race (Black/African American (OR 3.58 [95% CI 1.06-12.09], p=0.04), Asian (OR 3.94 [1.42-11.34], p=0.01)), non-English language (OR 0.28 [0.12-0.62], p=0.002), and marital status (married/significant other (OR 0.17 [0.06-0.41], p=0.0003)) but not sex, ethnicity or smoking status. There was no significant difference in 5-year survival according to depression status. Among 43 patients with depression, 28 (65%) were newly prescribed or continued antidepressants after HNC, and 11 (26%) were referred to mental health services. Non-English speakers were less likely to be prescribed an antidepressant (OR 0.44 [0.2-0.92], p=0.03).

Conclusions: Depression was less prevalent in our study population than has been previously reported. There was no association between depression and 5-year survival. Many patients with depression were prescribed antidepressants but a minority were referred to mental health services. Race, language and marital status were associated with depression but had mixed associations with access to mental health care.