Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
PLoS One. 2012;7(8):e42945. doi: 10.1371/journal.pone.0042945. Epub 2012 Aug 7.
Mood disorders may affect lung cancer risk. We evaluated this hypothesis in two large studies.
METHODOLOGY/PRINCIPAL FINDINGS: We examined 1,939 lung cancer cases and 2,102 controls from the Environment And Genetics in Lung cancer Etiology (EAGLE) case-control study conducted in Italy (2002-2005), and 82,945 inpatients with a lung cancer diagnosis and 3,586,299 person-years without a lung cancer diagnosis in the U.S. Veterans Affairs Inpatient Cohort (VA study), composed of veterans with a VA hospital admission (1969-1996). In EAGLE, we calculated odds ratios (ORs) and 95% confidence intervals (CI), with extensive adjustment for tobacco smoking and multiple lifestyle factors. In the VA study, we estimated lung cancer relative risks (RRs) and 95% CIs with time-dependent Poisson regression, adjusting for attained age, calendar year, hospital visits, time within the study, and related previous medical diagnoses. In EAGLE, we found decreased lung cancer risk in subjects with a personal history of mood disorders (OR: 0.59, 95% CI: 0.44-0.79, based on 121 lung cancer incident cases and 192 controls) and family history of mood disorders (OR: 0.62, 95% CI: 0.50-0.77, based on 223 lung cancer cases and 345 controls). The VA study analyses yielded similar results (RR: 0.74, 95% CI: 0.71-0.77, based on 2,304 incident lung cancer cases and 177,267 non-cancer person-years) in men with discharge diagnoses for mood disorders. History of mood disorders was associated with nicotine dependence, alcohol and substance use and psychometric scales of depressive and anxiety symptoms in controls for these studies.
CONCLUSIONS/SIGNIFICANCE: The consistent finding of a relationship between mood disorders and lung cancer risk across two large studies calls for further research into the complex interplay of risk factors associated with these two widespread and debilitating diseases. Although we adjusted for smoking effects in EAGLE, residual confounding of the results by smoking cannot be ruled out.
情绪障碍可能会影响肺癌的风险。我们在两项大型研究中评估了这一假说。
方法/主要发现：我们研究了意大利环境与肺癌病因学中的基因（EAGLE）病例对照研究中的 1939 例肺癌病例和 2102 例对照（2002-2005 年），以及美国退伍军人事务住院患者队列（VA 研究）中 82945 例肺癌住院患者和 3586299 人年无肺癌诊断的患者。在 EAGLE 中，我们计算了比值比（OR）和 95％置信区间（CI），并对吸烟和多种生活方式因素进行了广泛调整。在 VA 研究中，我们使用时间依赖性泊松回归估计了肺癌的相对风险（RR）和 95％CI，调整了获得的年龄、日历年份、就诊次数、研究期间的时间以及相关的既往医疗诊断。在 EAGLE 中，我们发现有个人情绪障碍病史的患者肺癌风险降低（OR：0.59，95％CI：0.44-0.79，基于 121 例肺癌新发病例和 192 例对照）和家族情绪障碍病史（OR：0.62，95％CI：0.50-0.77，基于 223 例肺癌病例和 345 例对照）。VA 研究分析结果在男性中也得出了类似的结果（RR：0.74，95％CI：0.71-0.77，基于 2304 例新发病例和 177267 例非癌症人年），这些男性有情绪障碍的出院诊断。在这些研究的对照中，情绪障碍史与尼古丁依赖、酒精和物质使用以及抑郁和焦虑症状的心理计量学量表有关。
结论/意义：两项大型研究中一致发现情绪障碍与肺癌风险之间存在关联，这需要进一步研究与这两种广泛且使人衰弱的疾病相关的危险因素之间的复杂相互作用。尽管我们在 EAGLE 中调整了吸烟的影响，但不能排除结果因吸烟而产生残余混杂的可能性。
