American Journal of Epidemiology Vol. 155, No. 12 : 1088-1095
Copyright © 2002 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Depression and Cancer Risk: A Register-based Study of Patients Hospitalized with Affective Disorders, Denmark, 1969–1993
1 Danish Cancer Society, Institute of Cancer Epidemiology, DK-2100 Copenhagen, Denmark.
2 National Center for Register-based Research, Aarhus University, DK-8000 Aarhus, Denmark.
The authors investigated the cancer risk of patients hospitalized for depression in a nationwide Danish cohort study. All 89,491 adults in Denmark who had been admitted to a hospital with depression, as defined in the International Classification of Diseases, Eighth Revision, between 1969 and 1993 were identified. There were 1,117,006 person-years of follow-up. Incidence rates of all cancers and of site-specific cancers were compared with national incidence rates for first primary cancers, with data being adjusted for sex, age, and calendar time. A total of 9,922 cases of cancer were diagnosed in the cohort, with 9,434.6 having been expected; this yielded a standardized incidence ratio of 1.05 (95% confidence interval (CI): 1.03, 1.07). The risk of cancer was increased for the first year after hospital admission, with brain cancer especially occurring more frequently than expected. When the first year of follow-up was excluded, the increase was attributable mainly to an increased risk of tobacco-related cancers: Standardized incidence ratios for non-tobacco-related cancers were 1.00 (95% CI: 0.97, 1.03) after 1–9 years of follow-up and 0.99 (95% CI: 0.95, 1.02) after 10 or more years of follow-up. These data provide no support for the hypothesis that depression independently increases risk of cancer, but they emphasize the deleterious effect that depression can have on lifestyle factors.
cohort studies; depression; neoplasms; registries
Abbreviations: CI, confidence interval; ICD-8, International Classification of Diseases, Eighth Revision; SIR, standardized incidence ratio
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