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Depression and cancer risk: 24 years of follow-up of the Baltimore Epidemiologic Catchment Area sample

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Abstract

Objective

The objective was to characterize the relationship between depression and incident cancer. Few studies have employed population-based prospective data on subtypes of cancer to address the question.

Method

A population-based sample of 3,177 cancer-free adults from the Baltimore Epidemiologic Catchment Area Study who have been followed for 24 years. Cox proportional hazards models were used to estimate relative hazards for both overall and subtype-specific cancers among those with a history of depression.

Results

The risk set contained 334 incident cancer cases and 40,530 person-years of observation. DIS/DSM-III major depression was associated with a higher hazard for overall cancer (HR: 1.9, 95% CI: 1.2, 3.0) and a statistically significant increased hazard for breast cancer (HR: 4.4, 95% CI: 1.08, 17.6) among women. There was a positive association between history of depression and prostate cancer, but confidence bounds included the null. No reliable associations were found between colon, lung, or skin cancers and depression. The pattern of results was similar for dysphoria, but not for phobia or any other mental disorder studied.

Conclusions

Results reveal a specificity to the association between depression and hormonally mediated cancers, which provides support to hypotheses about a common biological pathway between depression and cancer. Further research can build on observational studies to examine the mechanisms through which our emotions affect our health.

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References

  1. Snow HL (1893) Cancer and the cancer process. Churchill, London

    Google Scholar 

  2. McGee R, Williams S, Elwood M (1994) Depression and the development of cancer: a meta-analysis. Soc Sci Med 38:187–192

    Article  CAS  PubMed  Google Scholar 

  3. Oerlemans ME, van den Akker M, Schuurman AG, Kellen E, Buntinx F (2007) A meta-analysis on depression and subsequent cancer risk. Clin Pract Epidemiol Ment Health 3:29

    Article  Google Scholar 

  4. Olderoy G, Daehlin L, Ogreid D (1998) Low-frequency mutation of Ha-ras and Ki-ras oncogenes in transitional cell carcinoma of the bladder. Anticancer Res 18(4A):2675–2678

    CAS  PubMed  Google Scholar 

  5. Penninx BW, Guralnik JM, Pahor M et al (1998) Chronically depressed mood and cancer risk in older persons. J Natl Cancer Inst 90:1888–1893

    Article  CAS  PubMed  Google Scholar 

  6. Dalton SO, Mellemkjaer L, Olsen JH, Mortensen PB, Johansen C (2002) Depression and cancer risk: a register-based study of patients hospitalized with affective disorders, Denmark, 1969–1993. Am J Epidemiol 155:1088–1095

    Article  PubMed  Google Scholar 

  7. Thomas CB, McCabe OL (1980) Precursors of premature disease and death: habits of nervous tension. Johns Hopkins Med J 147:137–145

    CAS  PubMed  Google Scholar 

  8. Kaplan GA, Reynolds P (1988) Depression and cancer mortality and morbidity: prospective evidence from the Alameda County study. J Behav Med 11:1–13

    Article  CAS  PubMed  Google Scholar 

  9. Zonderman AB, Costa PT, McCrae RR (1989) Depression as a risk for cancer morbidity and mortality in a nationally representative sample. JAMA 262(9):1191–1195

    Article  CAS  PubMed  Google Scholar 

  10. Linkins RW, Comstock GW (1990) Depressed mood and development of cancer. Am J Epidemiol 132(5):962–972

    CAS  PubMed  Google Scholar 

  11. Vogt T, Pope C, Mullooly J, Hollis J (1994) Mental health status as a predictor of morbidity and mortality: a 15-year follow-up of members of a health maintenance organization. Am J Public Health 84:227–231

    Article  CAS  PubMed  Google Scholar 

  12. Knekt P, Raitasalo R, Heliövaara M et al (1996) Elevated lung cancer risk among persons with depressed mood. Am J Epidemiol 144(12):1096–1103

    CAS  PubMed  Google Scholar 

  13. Gallo JJ, Armenian HK, Ford DE, Eaton WW, Khachaturian AS (2000) Major depression and cancer: the 13-year follow-up of the Baltimore Epidemiologic Catchment Area sample (United States). Cancer Causes Control 11:751–758

    Article  CAS  PubMed  Google Scholar 

  14. van den Heuvel Gvd (1999) Comorbiditeit van depressie; scriptie wetenschapsstage. Nijmegen

  15. Schuurman A, van den Akker M, Ensinck KTJL, Metsemakers JF, Knottnerus A, Buntinx F (2001) Does depression induce susceptibility for somatic disease? NWO-report. Research Institute ExTra, Maastricht

    Google Scholar 

  16. Jacobs JR, Bovasso GB (2000) Early and chronic stress and their relation to breast cancer. Psychol Med 30:669–678

    Article  CAS  PubMed  Google Scholar 

  17. Kiecolt-Glaser JK, Robles TF, Heffner KL, Loving TJ, Glaser R (2002) Psycho-oncology and cancer: psychoneuroimmunology and cancer. Ann Oncol 13:165–169

    PubMed  Google Scholar 

  18. Glaser R, Thorn BE, Tarr KL, Kiecolt-Glaser JK, D’Ambrosio SM (1985) Effects of stress on methyltransferase synthesis: an important DNA repair enzyme. Br J Health Psychol 4:403–412

    Article  CAS  Google Scholar 

  19. Setlow RB (1978) Repair deficient human disorders and human cancer. Nature 271:713–717

    Article  CAS  PubMed  Google Scholar 

  20. Zorrilla EP, Luborsky L, McKay JR et al (2001) The relationship of depression and stressors to immunological assays: a meta-analytic review. Brain Behav Immun 15:199–226

    Article  CAS  PubMed  Google Scholar 

  21. Kissen DM (1963) Personality characteristics in males conducive to lung cancer. Br J Med Psychol 36:27–36

    CAS  PubMed  Google Scholar 

  22. LeShan LL (1959) Psychological states as factors in the development of malignant disease: a critical review. J Natl Cancer Inst 22:1–18

    CAS  PubMed  Google Scholar 

  23. Brewer JK (2008) Behavioral genetics of the depression/cancer correlation: a look at the Ras oncogene family and the ‘cerebral diabetes paradigm’. J Mol Neurosci 35(3):307–322

    Article  CAS  PubMed  Google Scholar 

  24. Mann JJ (1999) Role of the serotonergic system in the pathogenesis of major depression and suicidal behavior. Neuropsychopharmacology 21:99S–105S

    CAS  PubMed  Google Scholar 

  25. Muscat R, Papp M, Willner P (1992) Antidepressant-like effects of dopamine agonists in an animal model of depression. Biol Psychiatry 31:937–946

    Article  CAS  PubMed  Google Scholar 

  26. Willner P, Hale AS, Argyropoulos S (2005) Dopaminergic mechanism of antidepressant action in depressed patients. J Affect Disord 86:37–45

    Article  CAS  PubMed  Google Scholar 

  27. American Psychiatric Association (1980) Diagnostic and statistical manual of mental disorders, DSM-III, 3rd edn. American Psychiatric Association, Washington, DC

    Google Scholar 

  28. Eaton WW, Kalaydjian A, Scharfstein DO, Mezuk B, Ding Y (2007) Prevalence and incidence of depressive disorder: the Baltimore ECA follow-up, 1981–2004. Acta Psychiatr Scand 116:182–188

    Article  CAS  PubMed  Google Scholar 

  29. Eaton WW, Kessler LG (1985) Epidemiologic field methods in psychiatry: the NIMH epidemiologic catchment area program. Academic Press, New York

    Google Scholar 

  30. Eaton WW, Neufeld K, Chen LS, Cai G (2000) A comparison of self-report and clinical diagnostic interviews for depression: diagnostic interview schedule and schedules for clinical assessment in neuropsychiatry in the Baltimore Epidemiologic Catchment Area follow-up. Arch Gen Psychiatry 57:217–222

    Article  CAS  PubMed  Google Scholar 

  31. Cleves M, Gould W, Gutierrez R, Marchenko Y (2008) An introduction to survival analysis using Stata. Stata Press, College Station, TX

    Google Scholar 

  32. Hosmer D, Lemeshow S (1999) Applied survival analysis. Wiley, New York

    Google Scholar 

  33. Kessler RC, McGonagle KA, Zhao S et al (1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Study. Arch Gen Psychiatry 51:8–19

    CAS  PubMed  Google Scholar 

  34. Weissman MM, Leaf PJ, Tischler GL et al (1988) Affective disorders in five United States communities. Psychol Med 18:141–153

    Article  CAS  PubMed  Google Scholar 

  35. Anthony JC, Folstein M, Romanoski AJ et al (1985) Comparison of the lay Diagnostic Interview Schedule and a standardized psychiatric diagnosis. Arch Gen Psychiatry 42:667–675

    CAS  PubMed  Google Scholar 

  36. Schwartz AG, Ruckdeschel JC (2006) Familial lung cancer: genetic susceptibility and relationship to chronic obstructive pulmonary disease. Am J Respir Crit Care Med 173:16–22

    Article  CAS  PubMed  Google Scholar 

  37. Brenner H (2002) Long-term survival rates of cancer patients achieved by the end of the 20th century: a period analysis. Lancet 360:1131–1135

    Article  PubMed  Google Scholar 

  38. McEwen BS (2000) The neurobiology of stress: from serendipity to clinical relevance. Brain Res 886:172–189

    Article  CAS  PubMed  Google Scholar 

  39. Lutgendorf SK, Cole S, Costanzo E et al (2003) Stress-related mediators stimulate vascular endothelial growth factor secretion by two ovarian cancer cell lines. Clin Cancer Res 9:4514–4521

    CAS  PubMed  Google Scholar 

  40. Pulaski L, Kania K, Ratajewski M et al (2005) Differential regulation of the human MRP2 and MRP3 gene expression by glucocorticoids. J Steroid Biochem Mol Biol 96:229–234

    Article  CAS  PubMed  Google Scholar 

  41. Thaker PH, Han LY, Kamat AA et al (2006) Chronic stress promotes tumor growth and angiogenesis in a mouse model of ovarian carcinoma. Nat Med 12:939–944

    Article  CAS  PubMed  Google Scholar 

  42. Ticher A, Haus E, Ron IG et al (1996) The pattern of hormonal circadian time structure (acrophase) as an assessor of breast-cancer risk. Int J Cancer 65:591–593

    Article  CAS  PubMed  Google Scholar 

  43. Su F, Ouyang N, Zhu P et al (2005) Psychological stress induces chemoresistance in breast cancer by upregulating mdr1. Biochem Biophys Res Commun 329:888–897

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This work was supported by the National Institute of Mental Health (grants T32-MH14592, R01-MH47447, and F31-MH78443).

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Authors and Affiliations

  1. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 798 Hampton House, 624 N. Broadway, Baltimore, MD, 21205, USA

    Alden L. Gross

  2. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA

    Joseph J. Gallo

  3. Department of Family Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA

    Joseph J. Gallo

  4. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 850 Hampton House, 624 N. Broadway, Baltimore, MD, 21205, USA

    William W. Eaton

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  1. Alden L. Gross
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  2. Joseph J. Gallo
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  3. William W. Eaton
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Correspondence to Alden L. Gross.

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Gross, A.L., Gallo, J.J. & Eaton, W.W. Depression and cancer risk: 24 years of follow-up of the Baltimore Epidemiologic Catchment Area sample. Cancer Causes Control 21, 191–199 (2010). https://doi.org/10.1007/s10552-009-9449-1

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  • DOI: https://doi.org/10.1007/s10552-009-9449-1

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