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Depression, smoking, and lung cancer risk over 24 years among women
- Source :
- Psychol Med
- Publication Year :
- 2020
-
Abstract
- BackgroundStudies evaluating depression's role in lung cancer risk revealed contradictory findings, partly because of the small number of cases, short follow-up periods, and failure to account for key covariates including smoking exposure. We investigated the association of depressive symptoms with lung cancer risk in a large prospective cohort over 24 years while considering the role of smoking.MethodsWomen from the Nurses' Health Study completed measures of depressive symptoms, sociodemographics, and other factors including smoking in 1992 (N = 42 913). Depressive symptoms were also queried in 1996 and 2000, whereas regular antidepressant use and physician-diagnosed depression were collected starting in 1996. Multivariable Cox regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of lung cancer risk until 2016.ResultsWe identified 1009 cases of lung cancer. Women with the highest v. lowest level of depressive symptoms had an increased lung cancer risk (HRsociodemographics-adjusted = 1.62, 95% CI 1.34–1.95; HRfully-adjusted = 1.25, 95% CI 1.04–1.51). In a test of mediation, lifetime pack-years of smoking accounted for 38% of the overall association between depressive symptoms and disease risk. When stratifying by smoking status, the elevated risk was evident among former smokers but not current or never smokers; however, the interaction term suggested no meaningful differences across groups (p = 0.29). Results were similar or stronger when considering time-updated depression status (using depressive symptoms, physician diagnosis, and regular antidepressant use) and chronicity of depressive symptoms.ConclusionsThese findings suggest that greater depressive symptoms may contribute to lung cancer incidence, directly and indirectly via smoking habits, which accounted for over a third of the association.
- Subjects :
- medicine.medical_specialty
Lung Neoplasms
Article
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
Medicine
Humans
030212 general & internal medicine
Prospective Studies
Lung cancer
Prospective cohort study
Applied Psychology
Depression (differential diagnoses)
business.industry
Proportional hazards model
Depression
Incidence (epidemiology)
Incidence
Hazard ratio
Smoking
Cancer
medicine.disease
Confidence interval
Psychiatry and Mental health
030220 oncology & carcinogenesis
Female
business
Subjects
Details
- Language :
- English
- ISSN :
- 00332917
- Database :
- OpenAIRE
- Journal :
- Psychol Med
- Accession number :
- edsair.doi.dedup.....0eddb9f764ca945b62d37d83cc1ae126