Unveiling Anxiety and Depression Symptoms in Patients With Cancer: A Cross-Cultural Comparison Between Brazil and Mexico

Abstract

Background: Distress, including symptoms of anxiety and depression, is a common issue for patients with cancer. However, the prevalence and contributing factors can vary across regions due to cultural and systemic differences. This study aimed to assess distress prevalence among patients with cancer in Brazil and Mexico and explore the key factors influencing emotional well-being in these populations. Methods: A cross-sectional study was conducted involving patients from Brazil and Mexico. Participants completed standardized distress screening tools to assess symptoms of anxiety and depression, including the Generalized Anxiety Disorder 7-item scale (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9). Logistic regression analysis was performed to identify associations between distress symptoms and patient characteristics such as age, gender, cancer type, disease stage, and country of origin. Results: A total of 1105 patients with cancer were included in the final analysis. The majority of patients were female (64.8%), married (54.4%), and held at least a college degree (53.0%). The most common diagnosis was breast cancer (32.7%), and most patients were diagnosed at an advanced stage of disease (62.6%). Significant differences in distress prevalence between the two countries were found. Brazilian patients reported higher levels of anxiety symptoms, while Mexican patients exhibited more depressive symptoms (p < 0.001). Multivariate logistic regression showed that gender, age and disease stage were significantly associated with symptoms of anxiety (p < 0.01) and gender with symptoms of depression in both countries. Conclusion: Distress prevalence and its determinants vary across patients in Brazil and Mexico, influenced by cultural, systemic, and healthcare-related factors. Notably, these distress levels are greater than those reported in high-income countries. These findings highlight the need for culturally tailored screening and interventions to address region-specific distress patterns. Targeted psychosocial care can improve emotional well-being and quality of life for patients with cancer in Latin America.