{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:46:50Z","timestamp":1792028810022,"version":"4.4.0"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32CA117865"],"award-info":[{"award-number":["T32CA117865"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["DP2MH129967"],"award-info":[{"award-number":["DP2MH129967"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Support Care Cancer"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Informal caregivers are increasing in number, especially those caring for cancer patients, and caregiving can affect both patient outcomes and caregiver well-being. This study sought to elucidate whether the mental health outcomes differed among informal cancer caregivers, informal non-cancer caregivers, and non-caregivers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Data from 2022 and 2023 Behavioral Risk Factor Surveillance Surveys (BRFSS) were analyzed for 24 states administering the caregiving module. The sample included non-caregivers(\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009157,539), informal non-cancer caregivers (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200939,047), and informal cancer caregivers (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093,078). Logistic regressions identified factors associated with frequent mental distress days (FMD;\u2009\u2265\u20096\u00a0days of poor mental health in the last 30\u00a0days) and lifetime depression diagnosis. Models included caregiver status, reporting\u2009\u2265\u200914 poor physical health days monthly, exercise in the previous month, age, sex, marital status, education, employment, and rural\/urban status, adjusted for U.S. region and year.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In unadjusted comparisons, informal caregivers differed significantly from non-caregivers across several sociodemographic and health characteristics and were more likely to report FMD or a lifetime depression diagnosis. After adjusting for sociodemographics, year, U.S. region, physical health, and exercise, informal cancer caregivers had significantly higher odds of FMD than non-caregivers (aOR\u2009=\u20091.89, 95%CI\u2009=\u20091.58\u20132.26). Informal non-cancer caregivers had significantly higher odds of a lifetime depression diagnosis (aOR\u2009=\u20091.44, 95%CI\u2009=\u20091.36\u20131.52) than non-caregivers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cancer caregiving was more strongly associated with frequent mental distress than with lifetime depression. Integrating clinical screening into patient visits and informal caregiver supports could help identify caregiving distress during periods of increased burden and facilitate timely supportive care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00520-026-11337-y","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:39:34Z","timestamp":1792028374000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Poor mental health days and depressive disorders comparing non-caregivers, informal non-cancer caregivers, and informal caregivers of cancer patients: BRFSS 2022\u201323"],"prefix":"10.1007","volume":"34","author":[{"given":"Jeanne M.","family":"Ward","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R.","family":"Blosnich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Champion","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"issue":"4","key":"11337_CR1","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1007\/s11864-022-00955-3","volume":"23","author":"A Molassiotis","year":"2022","unstructured":"Molassiotis A, Wang M (2022) Understanding and supporting informal cancer caregivers. Curr Treat Options Oncol 23(4):494\u2013513","journal-title":"Curr Treat Options Oncol"},{"issue":"11","key":"11337_CR2","doi-asserted-by":"publisher","first-page":"1227","DOI":"10.1200\/JCO.2011.39.5798","volume":"30","author":"L Northouse","year":"2012","unstructured":"Northouse L, Williams A-l, Given B et al (2012) Psychosocial care for family caregivers of patients with cancer. J Clin Oncol 30(11):1227\u20131234","journal-title":"J Clin Oncol"},{"key":"11337_CR3","unstructured":"National Alliance for Caregiving. Cancer caregiving in the U.S. 2016 [Feb. 27, 2025]. Available from: https:\/\/www.caregiving.org\/wp-content\/uploads\/2022\/11\/CancerCaregivingReport_FINAL_June-17-2016.pdf"},{"key":"11337_CR4","unstructured":"American Cancer Society. Cancer Facts & Figures 2025 2025 [Feb. 27, 2025]. Available from: https:\/\/www.cancer.org\/content\/dam\/cancer-org\/research\/cancer-facts-and-statistics\/annual-cancer-facts-and-figures\/2025\/2025-cancer-facts-and-figures-acs.pdf"},{"issue":"1","key":"11337_CR5","first-page":"e70043","volume":"76","author":"RL Siegel","year":"2026","unstructured":"Siegel RL, Kratzer TB, Wagle NS et al (2026) Cancer statistics, 2026. Ca Cancer J Clin 76(1):e70043","journal-title":"Ca Cancer J Clin"},{"issue":"6","key":"11337_CR6","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1017\/S1478951517000050","volume":"15","author":"K Litzelman","year":"2017","unstructured":"Litzelman K, Blanch-Hartigan D, Lin CC et al (2017) Correlates of the positive psychological byproducts of cancer: role of family caregivers and informational support. Palliat Support Care 15(6):693\u2013703","journal-title":"Palliat Support Care"},{"issue":"2","key":"11337_CR7","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1007\/s00520-021-06440-1","volume":"30","author":"SR van der Kruk","year":"2022","unstructured":"van der Kruk SR, Butow P, Mesters I et al (2022) Psychosocial well-being and supportive care needs of cancer patients and survivors living in rural or regional areas: A systematic review from 2010 to 2021. Support Care Cancer 30(2):1021\u20131064","journal-title":"Support Care Cancer"},{"issue":"6","key":"11337_CR8","doi-asserted-by":"publisher","first-page":"5469","DOI":"10.1007\/s00520-022-06966-y","volume":"30","author":"Y Qian","year":"2022","unstructured":"Qian Y, Kent EE (2022) Gender differences in the association between unmet support service needs and mental health among American cancer caregivers. Support Care Cancer 30(6):5469\u20135480","journal-title":"Support Care Cancer"},{"issue":"3","key":"11337_CR9","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1016\/j.ygyno.2014.01.002","volume":"132","author":"PN Butow","year":"2014","unstructured":"Butow PN, Price MA, Bell ML et al (2014) Caring for women with ovarian cancer in the last year of life: a longitudinal study of caregiver quality of life, distress and unmet needs. Gynecol Oncol 132(3):690\u2013697","journal-title":"Gynecol Oncol"},{"issue":"5","key":"11337_CR10","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1016\/j.pec.2018.12.014","volume":"102","author":"RA Rodenbach","year":"2019","unstructured":"Rodenbach RA, Norton SA, Wittink MN et al (2019) When chemotherapy fails: emotionally charged experiences faced by family caregivers of patients with advanced cancer. Patient Educ Couns 102(5):909\u2013915","journal-title":"Patient Educ Couns"},{"issue":"Suppl 1","key":"11337_CR11","first-page":"84","volume":"54","author":"LC McGuire","year":"2007","unstructured":"McGuire LC, Strine TW, Vachirasudlekha S et al (2007) Modifiable characteristics of a healthy lifestyle and chronic health conditions in older adults with or without serious psychological distress, 2007 Behavioral Risk Factor Surveillance System. Int J Public Health 54(Suppl 1):84\u201393","journal-title":"Int J Public Health"},{"key":"11337_CR12","doi-asserted-by":"publisher","DOI":"10.1200\/op.21.00894","author":"CB Biddell","year":"2022","unstructured":"Biddell CB, Spees LP, Petermann V et al (2022) Financial assistance processes and mechanisms in rural and nonrural oncology care settings. JCO Oncol Pract. https:\/\/doi.org\/10.1200\/op.21.00894","journal-title":"JCO Oncol Pract"},{"issue":"4","key":"11337_CR13","doi-asserted-by":"publisher","first-page":"876","DOI":"10.1111\/jrh.12665","volume":"38","author":"KL Ratnapradipa","year":"2022","unstructured":"Ratnapradipa KL, Ranta J, Napit K et al (2022) Qualitative analysis of cancer care experiences among rural cancer survivors and caregivers. J Rural Health 38(4):876\u2013885","journal-title":"J Rural Health"},{"key":"11337_CR14","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6936a2","author":"RA Cree","year":"2018","unstructured":"Cree RA (2018) Frequent mental distress among adults, by disability status, disability type, and selected characteristics\u2014United States, 2018. MMWR Morb Mortal Wkly Rep. https:\/\/doi.org\/10.15585\/mmwr.mm6936a2","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"11337_CR15","volume-title":"Leading health indicators 2030: advancing health, equity, and well-being. Leading health indicators 2030: advancing health, equity, and well-being","author":"National Academies of Sciences E, Medicine, Health","year":"2020","unstructured":"National Academies of Sciences E, Medicine, Health et al (2020) Leading health indicators 2030: advancing health, equity, and well-being. Leading health indicators 2030: advancing health, equity, and well-being. National Academies Press (US), Washington (DC)"},{"issue":"5","key":"11337_CR16","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1007\/s00127-010-0204-4","volume":"46","author":"RM Bossarte","year":"2011","unstructured":"Bossarte RM, He H, Claassen CA et al (2011) Development and validation of a 6-day standard for the identification of frequent mental distress. Soc Psychiatry Psychiatr Epidemiol 46(5):403\u2013411","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"issue":"36","key":"11337_CR17","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.15585\/mmwr.mm6936a2","volume":"69","author":"RA Cree","year":"2018","unstructured":"Cree RA, Okoro CA, Zack MM et al (2018) Frequent mental distress among adults, by disability status, disability type, and selected characteristics \u2014United States, 2018. MMWR Morb Mortal Wkly Rep 69(36):1238\u20131243","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"11337_CR18","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1016\/j.jad.2023.08.054","volume":"340","author":"Z Monahan","year":"2023","unstructured":"Monahan Z, Shores D, Mack A et al (2023) Prevalence of depression among caregivers based on the condition and relationship of care recipient. J Affect Disord 340:442\u2013447","journal-title":"J Affect Disord"},{"issue":"7","key":"11337_CR19","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1177\/0193945920964936","volume":"43","author":"ML Longacre","year":"2020","unstructured":"Longacre ML, Brewer B, Hubbard A et al (2020) Caregiver health by context: moderating effects of mental health and health behaviors. West J Nurs Res 43(7):622\u2013630","journal-title":"West J Nurs Res"},{"issue":"4","key":"11337_CR20","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1016\/j.ejon.2011.09.001","volume":"16","author":"BS Fletcher","year":"2012","unstructured":"Fletcher BS, Miaskowski C, Given B et al (2012) The cancer family caregiving experience: an updated and expanded conceptual model. Eur J Oncol Nurs 16(4):387\u2013398","journal-title":"Eur J Oncol Nurs"},{"key":"11337_CR21","unstructured":"Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System 2024 [December 13, 2024]. Available from: Behavioral Risk Factor Surveillance System,"},{"key":"11337_CR22","unstructured":"Centers for Disease Control and Prevention. NCHS Urban-Rural Classification Scheme for Counties 2024 [February 3, 2025]. Available from: https:\/\/www.cdc.gov\/nchs\/data-analysis-tools\/urban-rural.html"},{"issue":"1","key":"11337_CR23","doi-asserted-by":"publisher","DOI":"10.1186\/s12963-017-0133-5","volume":"15","author":"L Dwyer-Lindgren","year":"1995","unstructured":"Dwyer-Lindgren L, Mackenbach JP, van Lenthe FJ et al (1995) Self-reported general health, physical distress, mental distress, and activity limitation by US county, 1995-2012. Popul Health Metr 15(1):16","journal-title":"Popul Health Metr"},{"key":"11337_CR24","unstructured":"New Mexico Department of Health. Adult frequent mental distress by year, New Mexico and U.S., 2004 to 2021 2023. Available from: https:\/\/ibis.doh.nm.gov\/indicator\/view\/MentHlthAdult.Year.NM_US.html?"},{"key":"11337_CR25","unstructured":"Centers for Disease Control and Prevention. Complex sampling weights and preparing 2022 BRFSS module data for analysis 2023 [June 9, 2025]. Available from: https:\/\/www.cdc.gov\/brfss\/annual_data\/2022\/pdf\/Complex-Sampling-Weights-and-Preparing-Module-Data-for-Analysis-2022-508.pdf"},{"key":"11337_CR26","unstructured":"Arizona Department of Health Services. Arizona 2022 Codebook Report Version 1 Behavioral Risk Factor Surveillance System 2023 [June 26, 2025]. Available from: https:\/\/www.azdhs.gov\/documents\/preparedness\/public-health-statistics\/behavioral-risk-factor-surveillance\/code-book\/az22code-llcp-v1.pdf"},{"key":"11337_CR27","unstructured":"Arizona Department of Health Services. Arizona 2022 Codebook Reprot Version 2 Behavioral Risk Factor Surveillance System 2023 [June 26, 2025]. Available from: https:\/\/www.azdhs.gov\/documents\/preparedness\/public-health-statistics\/behavioral-risk-factor-surveillance\/code-book\/az22code-llcp-v2.pdf"},{"key":"11337_CR28","unstructured":"New York State Department of Health. New York State Behavioral Risk Ractor Surveillance Survey: 2023 2025 [June 26, 2025]. Available from: https:\/\/health.data.ny.gov\/Health\/Behavioral-Risk-Factor-Surveillance-Survey-2023\/tk4g-wdfe\/about_data"},{"key":"11337_CR29","unstructured":"Wisconsin Department of Health Services. Wisconsin 2022 Codebook Report Behavioral Risk Factor Surveillance System 2023 [June 26, 2025]. Available from: https:\/\/www.dhs.wisconsin.gov\/stats\/2022-wi-brfss-codebook.pdf"},{"issue":"3","key":"11337_CR30","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.tjem.2018.08.001","volume":"18","author":"H Akoglu","year":"2018","unstructured":"Akoglu H (2018) User\u2019s guide to correlation coefficients. Turk J Emerg Med 18(3):91\u201393","journal-title":"Turk J Emerg Med"},{"issue":"1","key":"11337_CR31","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-14880-5","volume":"23","author":"R Chakraborty","year":"2023","unstructured":"Chakraborty R, Jana A, Vibhute VM (2023) Caregiving: a risk factor of poor health and depression among informal caregivers in India- a comparative analysis. BMC Public Health 23(1):42","journal-title":"BMC Public Health"},{"issue":"1","key":"11337_CR32","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1188\/13.ONF.53-61","volume":"40","author":"CE Mosher","year":"2013","unstructured":"Mosher CE, Bakas T, Champion VL (2013) Physical health, mental health, and life changes among family caregivers of patients with lung cancer. Oncol Nurs Forum 40(1):53\u201361","journal-title":"Oncol Nurs Forum"},{"key":"11337_CR33","doi-asserted-by":"publisher","first-page":"817936","DOI":"10.3389\/fpsyt.2022.817936","volume":"13","author":"YC Pan","year":"2022","unstructured":"Pan YC, Lin YS (2022) Systematic Review and Meta-Analysis of Prevalence of Depression Among Caregivers of Cancer Patients. Front Psychiatry 13:817936","journal-title":"Front Psychiatry"},{"issue":"10","key":"11337_CR34","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19105864","volume":"19","author":"P Janson","year":"2022","unstructured":"Janson P, Willeke K, Zaibert L et al (2022) Mortality, morbidity and health-related outcomes in informal caregivers compared to non-caregivers: a systematic review. Int J Environ Res Public Health 19(10):5864","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"11337_CR35","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-015-0309-2","volume":"13","author":"E Berglund","year":"2015","unstructured":"Berglund E, Lytsy P, Westerling R (2015) Health and wellbeing in informal caregivers and non-caregivers: a comparative cross-sectional study of the Swedish general population. Health Qual Life Outcomes 13(1):109","journal-title":"Health Qual Life Outcomes"},{"key":"11337_CR36","doi-asserted-by":"publisher","DOI":"10.5888\/pcd10.130090","volume":"10","author":"LA Anderson","year":"2013","unstructured":"Anderson LA, Edwards VJ, Pearson WS et al (2013) Adult caregivers in the United States: characteristics and differences in well-being, by caregiver age and caregiving status. Prev Chronic Dis 10:E135","journal-title":"Prev Chronic Dis"},{"issue":"2","key":"11337_CR37","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1093\/geront\/gnu177","volume":"55","author":"DL Roth","year":"2015","unstructured":"Roth DL, Fredman L, Haley WE (2015) Informal caregiving and its impact on health: a reappraisal from population-based studies. Gerontologist 55(2):309\u2013319","journal-title":"Gerontologist"},{"issue":"1","key":"11337_CR38","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-020-00594-1","volume":"19","author":"MG de Camargos","year":"2020","unstructured":"de Camargos MG, Paiva BSR, de Oliveira MA et al (2020) An explorative analysis of the differences in levels of happiness between cancer patients, informal caregivers and the general population. BMC Palliat Care 19(1):106","journal-title":"BMC Palliat Care"},{"issue":"2","key":"11337_CR39","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1037\/0882-7974.18.2.250","volume":"18","author":"M Pinquart","year":"2003","unstructured":"Pinquart M, S\u00f6rensen S (2003) Differences between caregivers and noncaregivers in psychological health and physical health: a meta-analysis. Psychol Aging 18(2):250","journal-title":"Psychol Aging"},{"issue":"1","key":"11337_CR40","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-025-13891-w","volume":"25","author":"T Anderson","year":"2025","unstructured":"Anderson T, Mitchell G, Prue G et al (2025) The psychosocial impact of pancreatic cancer on caregivers: a scoping review. BMC Cancer 25(1):511","journal-title":"BMC Cancer"},{"issue":"1","key":"11337_CR41","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-022-07468-7","volume":"31","author":"E Chong","year":"2022","unstructured":"Chong E, Crowe L, Mentor K et al (2022) Systematic review of caregiver burden, unmet needs and quality-of-life among informal caregivers of patients with pancreatic cancer. Support Care Cancer 31(1):74","journal-title":"Support Care Cancer"},{"key":"11337_CR42","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11192700","author":"I \u00d6z\u00f6nder\u00dcnal","year":"2023","unstructured":"\u00d6z\u00f6nder\u00dcnal I, Ordu C (2023) Decoding caregiver burden in cancer: role of emotional health, rumination, and coping mechanisms. Healthcare (Basel). https:\/\/doi.org\/10.3390\/healthcare11192700","journal-title":"Healthcare (Basel)"},{"key":"11337_CR43","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7334a2","author":"G Kilmer","year":"2015","unstructured":"Kilmer G (2015) Changes in health indicators among caregivers\u2014United States, 2015\u20132016 to 2021\u20132022. MMWR Morb Mortal Wkly Rep. https:\/\/doi.org\/10.15585\/mmwr.mm7334a2","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"11337_CR44","doi-asserted-by":"publisher","DOI":"10.1016\/j.xjmad.2023.100013","volume":"2","author":"NS Udupa","year":"2023","unstructured":"Udupa NS, Twenge JM, McAllister C et al (2023) Increases in poor mental health, mental distress, and depression symptoms among U.S. adults, 1993\u20132020. J Mood Anxiety Disord 2:100013","journal-title":"J Mood Anxiety Disord"},{"issue":"1","key":"11337_CR45","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1002\/pon.4441","volume":"27","author":"KM Trevino","year":"2018","unstructured":"Trevino KM, Prigerson HG, Maciejewski PK (2018) Advanced cancer caregiving as a risk for major depressive episodes and generalized anxiety disorder. Psychooncology 27(1):243\u2013249","journal-title":"Psychooncology"},{"key":"11337_CR46","doi-asserted-by":"crossref","unstructured":"Pan Y-C, Lin Ya-S. 2022 Systematic Review and Meta-Analysis of Prevalence of Depression Among Caregivers of Cancer Patients [Systematic Review]. Front Psychiatry. 2022 13","DOI":"10.3389\/fpsyt.2022.817936"}],"container-title":["Supportive Care in Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-026-11337-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00520-026-11337-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-026-11337-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:39:37Z","timestamp":1792028377000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00520-026-11337-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,14]]},"references-count":46,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["11337"],"URL":"https:\/\/doi.org\/10.1007\/s00520-026-11337-y","relation":{},"ISSN":["0941-4355","1433-7339"],"issn-type":[{"value":"0941-4355","type":"print"},{"value":"1433-7339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,14]]},"assertion":[{"value":"20 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 October 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1100"}}