Depressive symptoms and incident cancer risk in middle-aged and older Chinese adults: Findings from CHARLS

Depression and cancer are major public health concerns worldwide, particularly among aging populations. This study aims to investigate the association between depressive symptoms and incident cancer among middle-aged and older Chinese adults. We analyzed data from the 2015 to 2020 China Health and Retirement Longitudinal Study, a nationally representative cohort of Chinese adults aged 45 and older. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale at baseline. Incident cancer cases were identified through self-reported physician diagnoses during follow-up waves. Cox proportional hazard models were used to estimate the association between baseline depressive symptoms and subsequent cancer incidence, adjusting for sociodemographic factors, lifestyles, and health status. Among 13,132 participants (median age = 60 years, 46.9% male) without a history of cancer at baseline, 250 new cancer cases were identified over a median follow-up of 5.0 years. After adjusting for potential confounders, individuals with clinically significant depressive symptoms (10-item Center for Epidemiologic Studies Depression Scale score ≥10) had a 19.3% higher risk of developing cancer compared to those without (hazard ratio = 1.193, 95% confidence interval = 0.905-1.572, P = .210). This association persisted when categorized by the severity of depressive symptoms. Our findings suggest that depressive symptoms showed a nonsignificant trend toward increased risk of incident cancer in middle-aged and older Chinese adults. This underscores the importance of mental health screening and intervention in this population, potentially as part of a comprehensive strategy for cancer prevention. Further research is needed to elucidate the underlying mechanisms and to develop targeted interventions.