Depression and increased cancer risk: a 10-year population-based cohort study

This study aimed to clarify the association between depression and cancer risk, which remains uncertain.

A nationwide retrospective cohort study was conducted based on data from Korean adults without prior cancer who underwent health examinations between 2009 and 2010. Depression was identified using the diagnostic codes within two years before baseline. Incident cancer cases were ascertained through hospitalization and outpatient records during follow-up until 2019. Cox proportional hazards models estimated hazard ratios (HRs) for cancers, adjusting for demographic, socioeconomic, clinical variables and lifestyle. Additionally, subgroup analyses by sex and age and sensitivity analyses considering antidepressant use and a one-year lag period were performed.

Among 227,251 participants, depression was significantly associated with a risk of overall cancer (adjusted HR, 1.12; 95% CI, 1.07-1.17; p < 0.001), most notably in pancreatic cancer (adjusted HR, 1.44; 95% CI, 1.23-1.68; p < 0.001), with findings remaining consistent across subgroup and sensitivity analyses. Subgroup analyses showed a slightly stronger association in men (adjusted HR, 1.18; 95% CI, 1.11-1.26; p < 0.001) than in women (adjusted HR, 1.09; 95% CI, 1.02-1.17; p = 0.013).

Depression was associated with an increased risk of overall cancer, particularly pancreatic cancer. These findings underscore depression as a potential early indicator of cancer risk.