Introduction The mental health of gynecologic cancer survivors is under investigated. The Canadian Longitudinal Study on Aging (CLSA) includes >50,000 individuals aged 45–85 for 20 years and contains important psychosocial and self-reported data. We sought to evaluate factors contributing to current mental health outcomes among gynecologic cancer survivors.

Methods We performed a cross-sectional analysis of 26,155 female participants. Depression and psychological distress were measured using the Center for Epidemiological Studies Depression Scale (CES-D10) and the Kessler’s Psychological Distress Scale (K10), respectively. Self-rated mental health (SRMH) was measured using a five-point Likert scale. Regression analyses were performed, controlling for the complexity of the design and covariates.

Results Participants with a history of gynecologic cancer (n=765, weighted prevalence 2.9%, 95%CI 2.4–3.3) were more likely to screen positive for depression (OR_CES-D10 1.6, 95%CI 1.1–2.5). Low income (OR_CES-D10 1.8, 95%CI 1.1–3.2; OR_K10 8.8, 95%CI 3.3–23.7) and smoking (OR_CESD-10 4.9, 95%CI 2.5–9.7; OR_K10 3.6, 95%CI 1.7–10.9) were predictors of screening positive for depression and psychological distress. Non-white ethnicity was predictive of psychological distress (OR_K10 5.9, 95%CI 2.0–17.0). Low income (OR_SRMH 5.2, 95%CI 2.1–12.8) and multimorbidity (OR_SRMH 18.5, 95%CI 2.2–153.3) were predictors for low SRMH. Education, marital status and alcohol consumption were not found to be predictive of mental health outcomes.

Conclusion/Implications Participants with a history of gynecologic cancer are at increased risk of depression, particularly those faced with additional socioeconomic challenges and multimorbidity. Further research is required to address the mental health needs of patients with gynecologic cancers and to identify strategies towards sustained support throughout diagnosis and survivorship.