OBJECTIVE: This study aimed to study the comorbidity of common mental disorders (CMDs) and cancer, and the mental health treatment gap among community residents with active cancer, cancer survivors and cancer-free respondents in 13 high-income and 11 low-middle-income countries. METHODS: Data were derived from the World Mental Health Surveys (N = 66,387; n = 357 active cancer, n = 1373 cancer survivors, n = 64,657 cancer-free respondents). The World Health Organization/Composite International Diagnostic Interview was used in all surveys to estimate CMDs prevalence rates. Respondents were also asked about mental health service utilization in the preceding 12 months. Cancer status was ascertained by self-report of physician's diagnosis. RESULTS: Twelve-month prevalence rates of CMDs were higher among active cancer (18.4%, SE = 2.1) than cancer-free respondents (13.3%, SE = 0.2) adjusted for sociodemographic confounders and other lifetime chronic conditions (adjusted odds ratio (AOR) = 1.44, 95% CI 1.05-1.97). CMD rates among cancer survivors (14.6%, SE = 0.9) compared with cancer-free respondents did not differ significantly (AOR = 0.95, 95% CI 0.82-1.11). Similar patterns characterized high-income and low-middle-income countries. Of respondents with active cancer who had CMD in the preceding 12 months, 59% sought services for mental health problems (SE = 5.3). The pattern of service utilization among people with CMDs by cancer status (highest among persons with active cancer, lower among survivors and lowest among cancer-free respondents) was similar in high-income (64.0%, SE = 6.0; 41.2%, SE = 3.0; 35.6%, SE = 0.6) and low-middle-income countries (46.4%, SE = 11.0; 22.5%, SE = 9.1; 17.4%, SE = 0.7). CONCLUSIONS: Community respondents with active cancer have higher CMD rates and high treatment gap. Comprehensive cancer care should consider both factors.

The World Health Organization World Mental Health (WMH) Survey Initiative was supported by the National Institute of Mental Health (NIMH; R01 MH070884), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13‐MH066849, R01‐MH069864 and R01 DA016558), the Fogarty International Center (FIRCA R03‐TW006481). The São Paulo Megacity Mental Health Survey was supported by the State of São Paulo Research Foundation (FAPESP) Thematic Project Grant 03/00204‐3. The European surveys were funded by the European Commission (Contracts QLG5‐1999‐01042, SANCO 2004123 and EAHC 20081308), the Piedmont Region (Italy), Fondo de Investigación Sanitaria, Instituto de Salud Carlos III, Spain (FIS 00/0028), Ministerio de Ciencia y Tecnología, Spain (SAF 2000‐158‐CE), Departament de Salut, Generalitat de Catalunya, Spain, Instituto de Salud Carlos III (CIBER CB06/02/0046, RETICS RD06/0011 REM‐TAP). The World Mental Health Japan (WMHJ) Survey was supported by the Grant for Research on Psychiatric and Neurological Diseases and Mental Health (H13‐SHOGAI‐023, H14‐TOKUBETSU‐026 and H16‐KOKORO‐013) from the Japan Ministry of Health, Labour and Welfare. The Lebanese National Mental Health Survey (L.E.B.A.N.O.N.) was supported by the Lebanese Ministry of Public Health, the WHO (Lebanon), National Institute of Health/Fogarty International Center (R03 TW006481‐01). The Mexican National Comorbidity Survey (MNCS) was supported by The National Institute of Psychiatry Ramon de la Fuente (INPRFMDIES 4280) and by the National Council on Science and Technology (CONACyT‐G30544‐ H). The South Africa Stress and Health Study (SASH) was supported by the US National Institute of Mental Health (R01‐MH059575) and National Institute of Drug Abuse with supplemental funding from the South African Department of Health and the University of Michigan. The US National Comorbidity Survey Replication (NCS‐R) was supported by the National Institute of Mental Health (NIMH; U01‐MH60220), the Robert Wood Johnson Foundation (RWJF; Grant 044708)