Related Experiment Video
Updated: May 16, 2026
Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Association between Depression and Risk of Colorectal Cancer and Polyps: A Prospective Cohort Study from the Nurses'
Peenaprapa Tangpradubkiat1, Andrea L Roberts2, Bethsaida Cardona1,3
1Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Background:
Depression is a leading global health burden and has been linked to chronic diseases, including cancer. Chronic stress may promote colorectal carcinogenesis via hormonal, immune, and metabolic abnormalities. Evidence for the association between depression and colorectal cancer is inconsistent, and data on colorectal polyps are limited.
Methods:
We prospectively followed 91,383 women from the Nurses' Health Study II (1993-2019) for colorectal cancer analyses, and 62,237 women (1993-2017) for adenoma and serrated polyp analyses. Depression was defined as a Mental Health Index-5 score ≤52, antidepressant use, or physician-diagnosed depression. Multivariable Cox proportional hazards models estimated hazard ratios (HR) for colorectal cancer, whereas logistic regression estimated odds ratios (OR) for adenomas and serrated polyps.
Results:
Over 2.36 million person-years of follow-up, 474 colorectal cancer cases were documented. Depression was modestly associated with lower risk of colorectal cancer [HR = 0.76; 95% confidence interval (CI), 0.59-0.97] and colon cancer but not rectal cancer. Among 62,237 women undergoing lower endoscopy over 24 years, 4,104 conventional adenomas and 4,563 serrated polyps were documented. Depression was modestly inversely associated with overall and large conventional adenomas (OR = 0.76; 95% CI, 0.63-0.92). No consistent association was observed with serrated polyps in primary models, although some sensitivity analyses suggested possible positive associations.
Conclusions:
Depression was inversely associated with colorectal cancer and large conventional adenomas. Associations with serrated polyps were not evident in primary models but varied across sensitivity analyses, requiring further study.
Impact:
These findings suggest potential differences across colorectal neoplastic pathways, indicating that the relationship between depression and colorectal carcinogenesis may be more complex than previously appreciated.
Related Concept Videos
01:19Psychoneuroimmunology: Diabetes and Cancer
02:59Cancer Prevention
Some...
01:27Depressive Disorders: Etiology
Biological Factors in Depression
Biological predispositions significantly influence the risk of developing depressive disorders. Genetic studies highlight the role of variations in the serotonin transporter...
01:25Endoscopic Procedures II: Colonoscopy
01:27Psychoneuroimmunology: Cardiovascular Disease
A key area of focus in PNI is the relationship between stress and coronary...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...