© 1998 by Oxford University Press
Journal Of The National Cancer Institute, Vol 90, 1888-1893, Copyright © 1998 by Oxford University Press
BW Penninx, JM Guralnik, M Pahor, L Ferrucci, JR Cerhan, RB Wallace and RJ Havlik
BACKGROUND: Depression has been proposed as a predisposing factor for
cancer, but prospective studies have been inconclusive. We examined whether
a high level of depressive symptoms, present for a long time, is associated
with increased risk of cancer in the elderly. METHODS: Data were obtained
and analyzed from persons who lived in three communities (Massachusetts,
Iowa, and Connecticut) of the Established Populations for Epidemiologic
Studies of the Elderly, a prospective cohort study with a mean follow-up of
3.8 years that included 4825 persons (1708 men and 3117 women) aged 71
years and older. Chronically depressed mood was defined as present when the
number of depressive symptoms exceeded specific cut points on the Center
for Epidemiologic Studies-Depression scale at baseline (1988) and 3 and 6
years before baseline. New cases of cancer were identified from Medicare
hospitalization records and death certificates. RESULTS: Of the 4825
persons studied, 146 (3.0%) were chronically depressed. The incidence rate
of cancer was 30.5 per 1000 person-years for the 146 persons with chronic
depression and 21.9 per 1000 person-years for the 4679 nonchronically
depressed persons. After adjustment for age, sex, race, disability,
hospital admissions, alcohol intake, and smoking, the hazard ratio for
cancer associated with chronically depressed mood was 1.88 (95% confidence
interval = 1.13-3.14). The excess risk of cancer associated with chronic
depression was consistent for most types of cancer and was not specific to
cigarette smokers. CONCLUSION: When present for at least 6 years,
depression was associated with a generally increased risk of cancer.
ARTICLES
Chronically depressed mood and cancer risk in older persons
Epidemiology, Demography, and Biometry Program, National Institute on Aging, Bethesda, MD 20892, USA. BWJH.Penninx.EMGO@med.vu.nl
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