A meta-analysis on depression and subsequent cancer risk

Abstract

Background: The authors tested the hypothesis that depression is a possible factor influencing the course of cancer by reviewing prospective epidemiological studies and calculating summary relative risks. Methods: Studies were identified by computerized searches of Medline, Embase and PsycINFO. as well as manual searches of reference lists of selected publications. Inclusion criteria were cohort design, population-based sample, structured measurement of depression and outcome of cancer known for depressed and non-depressed subjects Results: Thirteen eligible studies were identified. Based on eight studies with complete crude data on overall cancer, our summary relative risk (95% confidence interval) was 1.19 (1.06-1.32). After adjustment for confounders we pooled a summary relative risk of 1.12 (0.99-1.26). No significant association was found between depression and subsequent breast cancer risk, based on seven heterogeneous studies, with or without adjustment for possible confounders. Subgroup analysis of studies with a follow-up of ten years or more, however, resulted in a statistically significant summary relative risk of 2.50 (1.06-5.91). Nosignificant associations were found for lung, colon or prostate cancer. Conclusion: This review suggests a tendency towards a small andmarginally significant association between depression and subsequent overall cancer risk and towards a stronger increase of breast cancer risk emerging many years after a previous depression. © 2007 Oerlemans et al; licensee BioMed Central Ltd.