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A meta-analysis on depression and subsequent cancer risk
Marjolein Ej Oerlemans1, Marjan van den Akker, Agnes G Schuurman
1Maastricht University, Department of General Practice, School of Public Health and Primary Care: CAPHRI, Maastricht, the Netherlands. Marjan.vandenakker@hag.unimaas.nl.
Background:
The authors tested the hypothesis that depression is a possible factor influencing the course of cancer by reviewing prospective epidemiological studies and calculating summary relative risks.
Methods:
Studies were identified by computerized searches of Medline, Embase and PsycINFO. as well as manual searches of reference lists of selected publications. Inclusion criteria were cohort design, population-based sample, structured measurement of depression and outcome of cancer known for depressed and non-depressed subjects
Results:
Thirteen eligible studies were identified. Based on eight studies with complete crude data on overall cancer, our summary relative risk (95% confidence interval) was 1.19 (1.06-1.32). After adjustment for confounders we pooled a summary relative risk of 1.12 (0.99-1.26).No significant association was found between depression and subsequent breast cancer risk, based on seven heterogeneous studies, with or without adjustment for possible confounders. Subgroup analysis of studies with a follow-up of ten years or more, however, resulted in a statistically significant summary relative risk of 2.50 (1.06-5.91).No significant associations were found for lung, colon or prostate cancer.
Conclusion:
This review suggests a tendency towards a small and marginally significant association between depression and subsequent overall cancer risk and towards a stronger increase of breast cancer risk emerging many years after a previous depression.
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