抑郁症、焦虑症与癌症风险：个体参与者数据的荟萃分析。
Depression, anxiety, and the risk of cancer: An individual participant data meta-analysis.
发表日期：2023 Aug 07
作者：
Lonneke A van Tuijl, Maartje Basten, Kuan-Yu Pan, Roel Vermeulen, Lützen Portengen, Alexander de Graeff, Joost Dekker, Mirjam I Geerlings, Adriaan Hoogendoorn, Femke Lamers, Adri C Voogd, Jessica Abell, Philip Awadalla, Aartjan T F Beekman, Ottar Bjerkeset, Andy Boyd, Yunsong Cui, Philipp Frank, Henrike Galenkamp, Bert Garssen, Sean Hellingman, Martijn Huisman, Anke Huss, Trynke R de Jong, Melanie R Keats, Almar A L Kok, Steinar Krokstad, Flora E van Leeuwen, Annemarie I Luik, Nolwenn Noisel, N Charlotte Onland-Moret, Yves Payette, Brenda W J H Penninx, Ina Rissanen, Annelieke M Roest, Rikje Ruiter, Robert A Schoevers, David Soave, Mandy Spaan, Andrew Steptoe, Karien Stronks, Erik R Sund, Ellen Sweeney, Emma L Twait, Alison Teyhan, W M Monique Verschuren, Kimberly D van der Willik, Judith G M Rosmalen, Adelita V Ranchor
来源：
CANCER
摘要：
长期以来，人们一直认为抑郁和焦虑与癌症风险增加有关。尽管已经进行了大量研究，但结果并不一致。为了更好地阐明抑郁、焦虑与各种癌症（总体、乳腺癌、肺癌、前列腺癌、结直肠癌、与饮酒相关的癌症和与吸烟相关的癌症）之间的关系，我们在心理社会因素和癌症发病（PSY-CA）协作组合内进行了个体参与者数据（IPD）的荟萃分析。PSY-CA协作组合包括来自18个队列的抑郁或焦虑测量数据（样本量为N=319,613；癌症发病数为25,803；随访人年为3,254,714）。我们同时考察了抑郁和焦虑的症状和诊断对未来癌症风险的预测能力。我们运用Cox回归模型在每个队列中进行了两阶段IPD荟萃分析，首先进行单队列分析（第一阶段），然后将结果在随机效应荟萃分析中进行综合（第二阶段）。结果显示，抑郁或焦虑与总体癌症、乳腺癌、前列腺癌、结直肠癌和与饮酒相关的癌症之间没有关联。抑郁和焦虑（症状和诊断）与肺癌和与吸烟相关的癌症的发病率有关（危险比[HR]，1.06-1.60）。然而，当进一步调整吸烟、饮酒和体重指数等已知风险因素时，这些关联大幅减弱（HR，1.04-1.23）。在大多数癌症结果上，抑郁和焦虑与风险增加无关，只有肺癌和与吸烟相关的癌症存在关联。这项研究显示关键共变量可能可以解释抑郁、焦虑与肺癌和与吸烟相关癌症之间的关系。PREREGISTRATION NUMBER：https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=157677。© 2023 作者。美国癌症学会代表Wiley Periodicals LLC出版《Cancer》。
Depression and anxiety have long been hypothesized to be related to an increased cancer risk. Despite the great amount of research that has been conducted, findings are inconclusive. To provide a stronger basis for addressing the associations between depression, anxiety, and the incidence of various cancer types (overall, breast, lung, prostate, colorectal, alcohol-related, and smoking-related cancers), individual participant data (IPD) meta-analyses were performed within the Psychosocial Factors and Cancer Incidence (PSY-CA) consortium.The PSY-CA consortium includes data from 18 cohorts with measures of depression or anxiety (up to N = 319,613; cancer incidences, 25,803; person-years of follow-up, 3,254,714). Both symptoms and a diagnosis of depression and anxiety were examined as predictors of future cancer risk. Two-stage IPD meta-analyses were run, first by using Cox regression models in each cohort (stage 1), and then by aggregating the results in random-effects meta-analyses (stage 2).No associations were found between depression or anxiety and overall, breast, prostate, colorectal, and alcohol-related cancers. Depression and anxiety (symptoms and diagnoses) were associated with the incidence of lung cancer and smoking-related cancers (hazard ratios [HRs], 1.06-1.60). However, these associations were substantially attenuated when additionally adjusting for known risk factors including smoking, alcohol use, and body mass index (HRs, 1.04-1.23).Depression and anxiety are not related to increased risk for most cancer outcomes, except for lung and smoking-related cancers. This study shows that key covariates are likely to explain the relationship between depression, anxiety, and lung and smoking-related cancers. PREREGISTRATION NUMBER: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=157677.© 2023 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.