© 1999 by Oxford University Press
Journal of the National Cancer Institute, Vol. 91, No. 9, 804,
May 5, 1999
© 1999 Oxford University Press
CORRESPONDENCE |
Re: Depression as a Risk Factor for Cancer: Renewing a Debate on the Psychobiology of Disease
Correspondence to: David S. David, M.D., F.A.C.P., Clinical Professor of Medicine, U.C.L.A. School of Medicine, 2222 Santa Monica Blvd., Suite 302, Santa Monica, CA 90404.
Croyle (1), in his excellent editorial regarding the very fine study by Penninx et al. (2), suggested that three areas of follow-up research would be indicated to further delineate the association between depression and cancer. One of those recommendations was to extend the study of a younger population, because it may be that the mechanisms responsible for the relationship between depression and cancer are related to the aging process.
I don't anticipate that a negative study in younger patients would justify the conclusion that aging is the cause of the association between depression and cancer death that was found in the study by Penninx et al. (2). Cancers in general have a long latency. As pointed out by Croyle, stress and depression have been associated with the causation and acceleration of cardiovascular disease. Cardiovascular disease tends to cause death at a younger age than does cancer. Therefore, one would have a common risk factor (for cardiovascular disease and cancer) and a competing cause of death (from cardiovascular disease and cancer), which would confound any epidemiologic study where death from cancer is in part or in whole an end point.
I think the main value of studies in younger patients would be to determine whether stress and depression can have an effect on the recurrence or progression of cancer. The fact that such an association is being found more frequently (3) would lend further credence to the study by Penninx et al.
REFERENCES
1
Croyle RT. Depression as a risk factor for cancer: renewing a
debate on the psychobiology of disease. J Natl Cancer Inst 1998;90:1856-57.
2
Penninx BW, Guralnik JM, Pahor N, Ferrucci L, Cerhan JR,
Wallace RB, et al. Chronically depressed mood and cancer risk in older persons. J Natl
Cancer Inst 1998;90:1888-93.
3
Spiegel D, Sephton SE, Terr AI, Stites DP. Effects of
psychosocial treatment in prolonging cancer survival may be mediated by neuroimmune
pathways. Ann N Y Acad Sci 1998;840:674-83.
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||