1. Association between depressive symptoms and second primary cancer in cancer survivors: Insights from a nationally representative study.
- Author
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Zhou, Jie, Liu, Xiaoxin, Liang, Xinjun, and Wei, Shaozhong
- Subjects
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PREVENTION of mental depression , *MENTAL depression risk factors , *RISK assessment , *CROSS-sectional method , *QUESTIONNAIRES , *MULTIPLE regression analysis , *HEALTH policy , *MULTIVARIATE analysis , *DESCRIPTIVE statistics , *SLEEP duration , *CANCER patient psychology , *CONFIDENCE intervals , *PUBLIC health , *SECONDARY primary cancer , *REGRESSION analysis - Abstract
The purpose of this study was to investigate the association between depressive symptoms and second primary cancer (SPC) in U.S. cancer survivors. Cancer survivors from the 2005–2018 National Health and Nutrition Examination Survey (NHANES) were included in this cross-sectional study, and depressive symptoms were defined by the Patient Health Questionnaire 9 (PHQ-9). The association between depressive symptoms and SPC was assessed via multiple logistic regression, restricted cubic spline (RCS), sensitivity, and subgroup analyses. This study involved 2315 participants representing >15 million noninstitutionalized U.S. residents. Multivariate logistic regression fully adjusted for confounders revealed that cancer survivors with a PHQ-9 score ≥ 10 had a greater risk of developing SPC than those with a PHQ-9 score of 0–4 ([OR] = 1.88, 95% [CI] = 1.20–2.89, p = 0.005). The RCS showed a linear positive correlation between the PHQ-9 score and SPC (p for overall = 0.017). The robustness of this association was subsequently confirmed via multiple interpolation of missing data and different cluster-level methods (namely weighted linear regression) as sensitivity analyses. Furthermore, subgroup analyses confirmed this correlation was stronger in participants with sleep duration <7 h (p for interaction = 0.036). Moderate to severe depressive symptoms in cancer survivors were associated with an increased risk of developing SPC, especially at <7 h of sleep. • Depressive symptoms may be positively associated with the risk of second primary cancer (SPC). • This study utilized NHANES data to provide a representative analysis of the U.S. population, providing broader implications for public health and policy. • Improving depression is a potential prevention strategy for SPC. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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