Am J Epidemiol. 2013 Dec 15;178(12):1712-20. doi: 10.1093/aje/kwt217. Epub 2013 Sep 30.
Depression has long been hypothesized to be associated with cancer incidence. However, there is evidence for a positive publication bias in this field. In the present study, we examined the association between various measures of depression and cancer incidence at several sites. A total of 14,203 members of the French GAZEL (Gaz et Electricité) cohort (10,506 men, 3,697 women) were followed up for diagnoses of primary cancers from January 1, 1994, to December 31, 2009. All medically certified sickness absences for depression recorded between January 1, 1990, and December 31, 1993, were compiled. Depressive symptoms were self-reported in 1993, 1996, and 1999 with the Center for Epidemiologic Studies Depression Scale. During a mean follow-up period of 15.2 years, 1,119 participants received a cancer diagnosis, excluding nonmelanoma skin cancer and in situ neoplasms. Considering 6 cancer sites (prostate, breast, colorectal, smoking-related, lymphoid and hematopoietic tissues, other sites) and 4 measures of depression, we found 1 positive association and 1 negative association. Overall, there was no compelling evidence for an association between depression and cancer incidence. Such null results should be considered when addressing concerns of cancer patients and their relatives about the role of depression in cancer onset.
抑郁与癌症发病率之间的关系长期以来一直被假设存在关联。然而,在该领域存在阳性发表偏倚的证据。在本研究中,我们检查了各种抑郁测量指标与多个部位癌症发病率之间的关联。从 1994 年 1 月 1 日至 2009 年 12 月 31 日,对法国 GAZEL(燃气和电力)队列的 14203 名成员(10506 名男性,3697 名女性)进行了原发性癌症诊断的随访。记录了 1990 年 1 月 1 日至 1993 年 12 月 31 日期间所有经医学证实的因抑郁而请的病假。1993 年、1996 年和 1999 年,使用流行病学研究中心抑郁量表报告了抑郁症状。在平均 15.2 年的随访期间,有 1119 名参与者被诊断患有癌症,不包括非黑素瘤皮肤癌和原位肿瘤。考虑到 6 个癌症部位(前列腺、乳房、结直肠、与吸烟相关、淋巴造血组织和其他部位)和 4 种抑郁测量指标,我们发现了 1 个阳性关联和 1 个阴性关联。总体而言,没有令人信服的证据表明抑郁与癌症发病率之间存在关联。在解决癌症患者及其亲属对抑郁在癌症发病中的作用的担忧时,应该考虑到这些无效结果。