Using Electronic Health Records to Assess Depression and Cancer Comorbidities

Comorbid diseases are an important concern in oncology since they can affect the choice and effectiveness of treatment. What is particularly relevant is the fact that the diagnosis of depression in cancer patients has an important impact on the quality of life of these patients. Although there is no consensus about a specific relationship of depression with certain cancer types, some authors have proposed that depression constitutes a risk factor for cancer. The objective of this study is to identify the presence of comorbidities in a massive EHR system, between depression and the 10 most common cancers in women and men and to determine if there is a preferred temporal ordering in the co-occurrence of these diseases. All the cancers studied showed a significant co-occurrence with depression, more specifically, twice more frequent than what could be expected by chance. A preferred directionality was identified between some of the comorbid diseases, such as breast cancer followed by depression, and depression followed by either stomach cancer, colorectal cancer or lung cancer. Future work will address other potential factors that have an influence on the likelihood of suffering from depression in patients with cancer, such as drug therapies received, exposure to substance of abuse or other comorbidities.