{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T07:04:31Z","timestamp":1790233471384,"version":"4.1.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Beijing Municipal Science & Technology Commission","award":["9212009"],"award-info":[{"award-number":["9212009"]}],"id":[{"id":"https:\/\/ror.org\/034k14f91","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100012325","name":"National Social Science Fund of China","doi-asserted-by":"publisher","award":["21&ZD187"],"award-info":[{"award-number":["21&ZD187"]}],"id":[{"id":"10.13039\/501100012325","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cancer, often described as a \u201cfamily disease,\u201d can negatively affect the mental health of spouses or partners through negative spillover effects. However, there is a lack of rigorous causal evidence regarding the spillover effects of cancer onset, and the dynamic pattern remains unclear. This study aims to assess the spillover effects of cancer onset on spousal depressive symptoms using a multicohort approach and examine the moderating role of a healthy lifestyle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a pooled multicountry analysis utilizing 21 countries datasets. We employed a causal inference research design, combining matching with difference-in-differences (DID) as the primary identification strategy to analyze the causal effect and its heterogeneity. Moreover, we conducted the interaction term analysis to explore the role of health lifestyles. Using an event study methodology, we examined the dynamic pattern and validated the parallel trends assumption.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our findings reveal a robust causal link between cancer onset and spousal depressive symptoms. Further analysis indicates that healthy lifestyles serve as a buffer against this adverse spillover effect, particularly reflected in moderate alcohol use (\u03b2 = \u22120.052, 95% confidence interval [CI] [\u22120.099, \u22120.005]), physical exercise (\u03b2 = \u22120.116, 95% CI [\u22120.183, \u22120.049]), social activities (\u03b2 = \u22120.126, 95% CI [\u22120.181, \u22120.071]), and tobacco use (\u03b2 \u2009=\u2009 0.100, 95% CI [0.029\u20130.171]). Additionally, the spillover effect exhibits a \u201cbimodal\u201d pattern, manifesting primarily in the short term (within 2\u2009years) and later stages (4\u20135\u2009years) of cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study reveals a dynamic negative impact of cancer on spousal mental health, closely related to the cancer trajectory and spousal behaviors. It underscores the imperative for establishing a family-based integrated care model for cancer. Future research should explore the underlying mechanisms of these spillover effects as well as develop care models to conduct prospective impact assessments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ije\/dyag209","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:33:58Z","timestamp":1788521638000},"source":"Crossref","is-referenced-by-count":0,"title":["Health behavior buffering the spillover effect of cancer on spousal depressive symptoms: causal evidence from a multicountry analysis"],"prefix":"10.1093","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6110-6296","authenticated-orcid":false,"given":"Yanshang","family":"Wang","sequence":"first","affiliation":[{"name":"School of Public Health, Peking University , Beijing,","place":["China"]},{"name":"China Center for Health Development Studies, Peking University , Beijing,","place":["China"]},{"name":"Division of Psychiatry, Faculty of Brain Science, University College London , London,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiqi","family":"Xia","sequence":"additional","affiliation":[{"name":"School of Public Health, Peking University , Beijing,","place":["China"]},{"name":"China Center for Health Development Studies, Peking University , Beijing,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang","family":"Cai","sequence":"additional","affiliation":[{"name":"School of Public Health, Imperial College London , London,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenyu","family":"Shi","sequence":"additional","affiliation":[{"name":"School of Public Health, Peking University , Beijing,","place":["China"]},{"name":"China Center for Health Development Studies, Peking University , Beijing,","place":["China"]},{"name":"School of Social Development, University of Health and Rehabilitation Sciences, Shandong,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5040-5012","authenticated-orcid":false,"given":"Ping","family":"He","sequence":"additional","affiliation":[{"name":"China Center for Health Development Studies, Peking University , Beijing,","place":["China"]},{"name":"Beijing Institute of Health Development, Peking University , Beijing,","place":["China"]},{"name":"National Health Commission Key Laboratory of Health System Reform and Governance, Peking University , Beijing,","place":["China"]},{"name":"State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University , Beijing,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"2026092402435174300_dyag209-B1","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1097\/00002820-200106000-00010","article-title":"Partner understanding of the breast and prostate cancer experience","volume":"24","author":"Carlson","year":"2001","journal-title":"Cancer Nurs"},{"key":"2026092402435174300_dyag209-B2","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1097\/NCC.0000000000000493","article-title":"The effect of cancer patients\u2019 and their family caregivers\u2019 physical and emotional symptoms on caregiver burden","volume":"41","author":"Johansen","year":"2018","journal-title":"Cancer Nurs"},{"key":"2026092402435174300_dyag209-B3","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.1002\/cncr.29223","article-title":"When do we need to care about the caregiver? 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