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Purpose: The aim of this study is to assess mental health services utilization and expenditures associated with cancer history using a nationally representative sample in the US. Methods: We used data from the 2008-2011 Medical Expenditure Panel Survey and multivariate regression models to assess mental health services use and expenditures among cancer survivors compared to individuals without a cancer history, stratified by age (18-64 and ≥65 years) and time since diagnosis (≤1 vs. >1 year). Results: Among adults aged 18-64, compared with individuals without a cancer history, cancer survivors were more likely to screen positive for current psychological distress and depression regardless of time since diagnosis; survivors diagnosed >1 year ago were more likely to use mental health prescription drugs; those diagnosed within 1 year reported significantly lower annual per capita mental health drug expenditure and out-of-pocket mental health expenditure, while those diagnosed >1 year presented significantly higher annual per capita mental health expenditure. No significant differences in mental health expenditures were found among adults aged 65 or older. Conclusions: Mental health problems presented higher health and economic burden among younger and longer-term survivors than individuals without a cancer history. This study provides data for monitoring the impact of initiatives to enhance coverage and access for mental health services at the national level. Implications for cancer survivors: Early detection and appropriate treatment of mental health problems may help improve quality of cancer survivorship. [ABSTRACT FROM AUTHOR]