Alwhaibi Monira, Sambamoorthi Usha, Madhavan Suresh, Bias Thomas, Kelly Kimberly, Walkup James
Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, West Virginia
Department of Clinical Pharmacy, School of Pharmacy, King Saud University, Saudi Arabia
J Natl Compr Canc Netw. 2017 Jan;15(1):46-55. doi: 10.6004/jnccn.2017.0006.
Elderly individuals (age >65 years) with cancer are at high risk for newly diagnosed depression after a cancer diagnosis. It is not known whether the risk of newly diagnosed depression varies by cancer type.
To examine the variations in the risk of newly diagnosed depression by cancer type among elderly individuals with cancer.
This study used a retrospective cohort study design and data from the linked SEER-Medicare files. Elderly individuals (age >65 years) with incident breast, colorectal (CRC), and prostate cancers diagnosed between 2007 and 2011 (N=53,821) were followed for 12 months after cancer diagnosis. Depression diagnosis was identified during the 12-month follow-up period after cancer diagnosis using the ICD-9-Clinical Modification. Complementary log-log regression was used to examine the association between cancer type and risk of newly diagnosed depression after adjusting for other risk factors for depression.
We found a significantly higher percentage of newly diagnosed depression among women with CRC compared with those with breast cancer (5.8% vs 3.9%), and among men with CRC compared with those with prostate cancer (3.4% vs 1.6%). In the adjusted analysis, women with CRC had a 28.0% higher risk of newly diagnosed depression compared with women with breast cancer (adjusted risk ratio [ARR], 1.28; 95% CI, 1.12-1.46) and men with CRC had a 104.0% higher risk of newly diagnosed depression compared with those with prostate cancer (ARR, 2.04; 95% CI, 1.65-2.51).
Our findings identified cancer types associated with a high risk of newly diagnosed depression after cancer diagnosis, who might benefit from routine depression screening to help in its early detection and treatment.
癌症老年患者（年龄>65岁）在癌症确诊后有新诊断出抑郁症的高风险。尚不清楚新诊断出抑郁症的风险是否因癌症类型而异。
研究癌症老年患者中，新诊断出抑郁症的风险因癌症类型的差异。
本研究采用回顾性队列研究设计，并使用来自SEER - 医疗保险关联文件的数据。对2007年至2011年间确诊的乳腺癌、结直肠癌（CRC）和前列腺癌的老年患者（年龄>65岁，N = 53,821）在癌症确诊后进行12个月的随访。在癌症确诊后的12个月随访期内，使用国际疾病分类第九版临床修订本（ICD - 9 - CM）确定抑郁症诊断。在调整了其他抑郁症风险因素后，使用互补对数-对数回归分析来研究癌症类型与新诊断出抑郁症风险之间的关联。
我们发现，结直肠癌女性患者中新诊断出抑郁症的比例显著高于乳腺癌女性患者（5.8%对3.9%），结直肠癌男性患者中新诊断出抑郁症的比例显著高于前列腺癌男性患者（3.4%对1.6%）。在调整分析中，结直肠癌女性患者新诊断出抑郁症的风险比乳腺癌女性患者高28.0%（调整风险比[ARR]，1.28；95%置信区间[CI]，1.12 - 1.46），结直肠癌男性患者新诊断出抑郁症的风险比前列腺癌男性患者高104.0%（ARR，2.04；95% CI，1.65 - 2.51）。
我们的研究结果确定了癌症确诊后与新诊断出抑郁症高风险相关的癌症类型，这些患者可能受益于常规抑郁症筛查，以帮助早期发现和治疗。
