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Depression, smoking, and lung cancer risk over 24 years among women

Published online by Cambridge University Press:  03 December 2020

Claudia Trudel-Fitzgerald Open the ORCID record for Claudia Trudel-Fitzgerald [Opens in a new window] ,
Emily S. Zevon ,
Ichiro Kawachi ,
Reginald D. Tucker-Seeley  and
Laura D. Kubzansky
Claudia Trudel-Fitzgerald*
Affiliation:
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA
Emily S. Zevon
Affiliation:
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA
Ichiro Kawachi
Affiliation:
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA
Reginald D. Tucker-Seeley
Affiliation:
Leonard Davis School of Gerontology, University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, USA
Laura D. Kubzansky
Affiliation:
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA
*
Author for correspondence: Dr Claudia Trudel-Fitzgerald, E-mail: ctrudel@hsph.harvard.edu
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Abstract

Background

Studies 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.

Methods

Women 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.

Results

We 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.

Conclusions

These 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.

Keywords

Antidepressantcancerdepressionlung cancersmoking
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 13 , October 2022 , pp. 2510 - 2519
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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References

American Cancer Society. (2020). Cancer Facts & Figures 2020. Retrieved from Atlanta: https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2020.html.Google Scholar
Arrieta, O., Angulo, L. P., Nunez-Valencia, C., Dorantes-Gallareta, Y., Macedo, E. O., Martinez-Lopez, D., … Onate-Ocana, L. F. (2013). Association of depression and anxiety on quality of life, treatment adherence, and prognosis in patients with advanced non-small cell lung cancer. Annals of Surgical Oncology, 20(6), 1941–1948. doi: 10.1245/s10434-012-2793-5CrossRefGoogle ScholarPubMed
Bao, Y., Bertoia, M. L., Lenart, E. B., Stampfer, M. J., Willett, W. C., Speizer, F. E., & Chavarro, J. E. (2016). Origin, methods, and evolution of the three Nurses' Health Studies. American Journal of Public Health, 106(9), 1573–1581.CrossRefGoogle ScholarPubMed
Berwick, D. M., Murphy, J. M., Goldman, P. A. Jr., Ware, J. E., Barsky, A. J., & Weinstein, M. C. (1991). Performance of a five-item mental health screening test. Medical Care, 29(2), 169–176.CrossRefGoogle ScholarPubMed
Blumberg, E. M., West, P. M., & Ellis, F. W. (1954). A possible relationship between psychological factors and human cancer. Psychosomatic Medicine, 16(4), 277–286.CrossRefGoogle ScholarPubMed
Boden, J. M., Fergusson, D. M., & Horwood, L. J. (2010). Cigarette smoking and depression: Tests of causal linkages using a longitudinal birth cohort. British Journal of Psychiatry, 196(6), 440–446. doi: 10.1192/bjp.bp.109.065912CrossRefGoogle ScholarPubMed
Brenner, D. R., Yannitsos, D. H., Farris, M. S., Johansson, M., & Friedenreich, C. M. (2016). Leisure-time physical activity and lung cancer risk: A systematic review and meta-analysis. Lung Cancer, 95, 17–27. doi: 10.1016/j.lungcan.2016.01.021CrossRefGoogle ScholarPubMed
Chasan-Taber, S., Rimm, E. B., Stampfer, M. J., Spiegelman, D., Colditz, G. A., Giovannucci, E., … Willett, W. C. (1996). Reproducibility and validity of a self-administered physical activity questionnaire for male health professionals. Epidemiology, 7(1), 81–86.CrossRefGoogle ScholarPubMed
Cohen, B. E., Edmondson, D., & Kronish, I. M. (2015). State of the art review: Depression, stress, anxiety, and cardiovascular disease. American Journal of Hypertension, 28(11), 1295–1302.CrossRefGoogle Scholar
Cooper, J., Borland, R., McKee, S. A., Yong, H. H., & Dugue, P. A. (2016). Depression motivates quit attempts but predicts relapse: Differential findings for gender from the International Tobacco Control Study. Addiction, 111(8), 1438–1447. doi: 10.1111/add.13290CrossRefGoogle ScholarPubMed
Cuijpers, P., van Straten, A., van Schaik, A., & Andersson, G. (2009). Psychological treatment of depression in primary care: A meta-analysis. British Journal of General Practice, 59(559), e51–e60. doi: 10.3399/bjgp09X395139CrossRefGoogle ScholarPubMed
Dalton, S. O., Mellemkjaer, L., Olsen, J. H., Mortensen, P. B., & Johansen, C. (2002). Depression and cancer risk: A register-based study of patients hospitalized with affective disorders, Denmark, 1969–1993. American Journal of Epidemiology, 155(12), 1088–1095.CrossRefGoogle Scholar
Donington, J. S., & Colson, Y. L. (2011). Sex and gender differences in non-small cell lung cancer. Seminars in Thorac and Cardiovascular Surgery, 23(2), 137–145. doi: 10.1053/j.semtcvs.2011.07.001CrossRefGoogle ScholarPubMed
Gidron, Y., Russ, K., Tissarchondou, H., & Warner, J. (2006). The relation between psychological factors and DNA-damage: A critical review. Biological Psychology, 72(3), 291–304. doi: 10.1016/j.biopsycho.2005.11.011CrossRefGoogle ScholarPubMed
Giovannucci, E., Colditz, G., Stampfer, M. J., Rimm, E. B., Litin, L., Sampson, L., & Willett, W. C. (1991). The assessment of alcohol consumption by a simple self-administered questionnaire. American Journal of Epidemiology, 133(8), 810–817.CrossRefGoogle ScholarPubMed
Glaser, R., & Kiecolt-Glaser, J. K. (2005). Stress-induced immune dysfunction: Implications for health. Nature Reviews Immunology, 5(3), 243–251. doi: 10.1038/nri1571CrossRefGoogle ScholarPubMed
Goldacre, M. J., Wotton, C. J., Yeates, D., Seagroatt, V., & Flint, J. (2007). Cancer in people with depression or anxiety: Record-linkage study. Social Psychiatry and Psychiatric Epidemiology, 42(9), 683–689.CrossRefGoogle ScholarPubMed
Green McDonald, P., O'Connell, M., & Lutgendorf, S. K. (2013). Psychoneuroimmunology and cancer: A decade of discovery, paradigm shifts, and methodological innovations. Brain, Behavior, and Immunity, 30(Suppl), S1–S9.CrossRefGoogle ScholarPubMed
Green McDonald, P., O'Connell, M., & Suls, J. (2015). Cancer control falls squarely within the province of the psychological sciences. American Psychologist, 70(2), 61–74. doi: 10.1037/a0038873CrossRefGoogle ScholarPubMed
Gross, A. L., Gallo, J. J., & Eaton, W. W. (2010). Depression and cancer risk: 24 years of follow-up of the Baltimore epidemiologic catchment area sample. Cancer Causes & Control, 21(2), 191–199. doi: 10.1007/s10552-009-9449-1CrossRefGoogle ScholarPubMed
Hasin, D. S., Sarvet, A. L., Meyers, J. L., Saha, T. D., Ruan, W. J., Stohl, M., & Grant, B. F. (2018). Epidemiology of adult DSM-5 major depressive disorder and its specifiers in the United States. JAMA Psychiatry, 75(4), 336–346. doi: 10.1001/jamapsychiatry.2017.4602CrossRefGoogle ScholarPubMed
Huang, T., Poole, E. M., Okereke, O. I., Kubzansky, L. D., Eliassen, A. H., Sood, A. K., … Tworoger, S. S. (2015). Depression and risk of epithelial ovarian cancer: Results from two large prospective cohort studies. Gynecologic Oncology, 139(3), 481–486.CrossRefGoogle ScholarPubMed
Jeon, J., Holford, T. R., Levy, D. T., Feuer, E. J., Cao, P., Tam, J., … Meza, R. (2018). Smoking and lung cancer mortality in the United States from 2015 to 2065: A comparative modeling approach. Annals of Internal Medicine, 169(10), 684–693. doi: 10.7326/M18-1250CrossRefGoogle ScholarPubMed
Karami, S., Han, Y., Pande, M., Cheng, I., Rudd, J., Pierce, B. L., … Tricl. (2016). Telomere structure and maintenance gene variants and risk of five cancer types. International Journal of Cancer, 139(12), 2655–2670. doi: 10.1002/ijc.30288CrossRefGoogle ScholarPubMed
Kessler, R. C. (2003). Epidemiology of women and depression. Journal of Affective Disorders, 74(1), 5–13.CrossRefGoogle ScholarPubMed
Knekt, P., Raitasalo, R., Heliovaara, M., Lehtinen, V., Pukkala, E., Teppo, L., … Aromaa, A. (1996). Elevated lung cancer risk among persons with depressed mood. American Journal of Epidemiology, 144(12), 1096–1103.CrossRefGoogle ScholarPubMed
Kroenke, C. H., Bennett, G. G., Fuchs, C., Giovannucci, E., Kawachi, I., Schernhammer, E., … Kubzansky, L. D. (2005). Depressive symptoms and prospective incidence of colorectal cancer in women. American Journal of Epidemiology, 162(9), 839–848.CrossRefGoogle ScholarPubMed
Leventhal, A. M., & Zvolensky, M. J. (2015). Anxiety, depression, and cigarette smoking: A transdiagnostic vulnerability framework to understanding emotion-smoking comorbidity. Psychological Bulletin, 141(1), 176–212.CrossRefGoogle ScholarPubMed
Liang, J. A., Sun, L. M., Muo, C. H., Sung, F. C., Chang, S. N., & Kao, C. H. (2011). The analysis of depression and subsequent cancer risk in Taiwan. Cancer Epidemiology, Biomarkers & Prevention, 20(3), 473–475. doi: 10.1158/1055-9965.EPI-10-1280CrossRefGoogle ScholarPubMed
Luijendijk, H. J., van den Berg, J. F., Dekker, M. J., van Tuijl, H. R., Otte, W., Smit, F., … Tiemeier, H. (2008). Incidence and recurrence of late-life depression. Archives of General Psychiatry, 65(12), 1394–1401. doi: 10.1001/archpsyc.65.12.1394CrossRefGoogle ScholarPubMed
McCullough, M. L., Feskanich, D., Stampfer, M. J., Giovannucci, E. L., Rimm, E. B., Hu, F. B., … Willett, W. C. (2002). Diet quality and major chronic disease risk in men and women: Moving toward improved dietary guidance. American Journal of Clinical Nutrition, 76(6), 1261–1271.CrossRefGoogle ScholarPubMed
Meng, S., De Vivo, I., Liang, L., Hu, Z., Christiani, D. C., Giovannucci, E., & Han, J. (2016). Pre-diagnostic leukocyte mitochondrial DNA copy number and risk of lung cancer. Oncotarget, 7(19), 27307–27312. doi: 10.18632/oncotarget.8426CrossRefGoogle ScholarPubMed
National Academies of Sciences, Engineering, and Medicine. (2019). Factors contributing to clinician burnout and professional well-being. In Taking action against clinician burnout: A systems approach to professional well-being (pp. 81–126). Washington, DC: The National Academies Press.Google Scholar
National Survey on Drug Use and Health. (2017). Major depression: Prevalence of major depressive episode among adults. Retrieved from https://www.nimh.nih.gov/health/statistics/major-depression.shtml#part_155033Google Scholar
Penninx, B. W., Guralnik, J. M., Pahor, M., Ferrucci, L., Cerhan, J. R., Wallace, R. B., & Havlik, R. J. (1998). Chronically depressed mood and cancer risk in older persons. Journal of the National Cancer Institute, 90(24), 1888–1893.CrossRefGoogle ScholarPubMed
Pirl, W. F., Greer, J. A., Traeger, L., Jackson, V., Lennes, I. T., Gallagher, E. R., … Temel, J. S. (2012). Depression and survival in metastatic non-small-cell lung cancer: Effects of early palliative care. Journal of Clinical Oncology, 30(12), 1310–1315. doi: 10.1200/JCO.2011.38.3166CrossRefGoogle ScholarPubMed
Rich-Edwards, J. W., Corsano, K. A., & Stampfer, M. J. (1994). Test of the national death index and equifax nationwide death search. American Journal of Epidemiology, 140(11), 1016–1019.CrossRefGoogle ScholarPubMed
Rimm, E. B., Giovannucci, E. L., Stampfer, M. J., Colditz, G. A., Litin, L. B., & Willett, W. C. (1992). Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals. American Journal of Epidemiology, 135(10), 1114–1126, discussion 1127-1136.CrossRefGoogle ScholarPubMed
Rumpf, H. J., Meyer, C., Hapke, U., & John, U. (2001). Screening for mental health: Validity of the MHI-5 using DSM-IV axis I psychiatric disorders as gold standard. Psychiatry Research, 105(3), 243–253.CrossRefGoogle ScholarPubMed
SAS Institute. (2011). The SAS sytem for windows. Cary, NC: SAS Institute.Google Scholar
Schernhammer, E. S., Feskanich, D., Liang, G., & Han, J. (2013). Rotating night-shift work and lung cancer risk among female nurses in the United States. American Journal of Epidemiology, 178(9), 1434–1441. doi: 10.1093/aje/kwt155CrossRefGoogle ScholarPubMed
Spiegel, D., & Giese-Davis, J. (2003). Depression and cancer: Mechanisms and disease progression. Biological Psychiatry, 54(3), 269–282.CrossRefGoogle ScholarPubMed
Sullivan, D. R., Ganzini, L., Duckart, J. P., Lopez-Chavez, A., Deffebach, M. E., Thielke, S. M., & Slatore, C. G. (2014). Treatment receipt and outcomes among lung cancer patients with depression. Clinical Oncology (Royal College of Radiologists), 26(1), 25–31. doi: 10.1016/j.clon.2013.09.001CrossRefGoogle ScholarPubMed
Sun, Y., Li, Z., Li, J., Li, Z., & Han, J. (2016). A healthy dietary pattern reduces lung cancer risk: A systematic review and meta-analysis. Nutrients, 8(3), 134. doi: 10.3390/nu8030134CrossRefGoogle ScholarPubMed
Trudel-Fitzgerald, C., Chen, Y., Singh, A., Okereke, O. I., & Kubzansky, L. D. (2016a). Psychiatric, psychological, and social determinants of health in the Nurses' Health Study cohorts. American Journal of Public Health, 106(9), 1644–1649.CrossRefGoogle Scholar
Trudel-Fitzgerald, C., Tworoger, S. S., Poole, E. M., Williams, D. R., & Kubzansky, L. D. (2016b). Prospective changes in healthy lifestyle among midlife women: When psychological symptoms get in the way. American Journal of Preventive Medicine, 51(3), 327–335.CrossRefGoogle Scholar
Valeri, L., & Vanderweele, T. J. (2013). Mediation analysis allowing for exposure-mediator interactions and causal interpretation: Theoretical assumptions and implementation with SAS and SPSS macros. Psychological Methods, 18(2), 137–150.CrossRefGoogle ScholarPubMed
VanderWeele, T. J. (2011). Causal mediation analysis with survival data. Epidemiology, 22(4), 582–585. doi: 10.1097/EDE.0b013e31821db 37eCrossRefGoogle ScholarPubMed
VanderWeele, T. J. (2013). A three-way decomposition of a total effect into direct, indirect, and interactive effects. Epidemiology, 24(2), 224–232. doi: 10.1097/EDE.0b013e318281a64eCrossRefGoogle ScholarPubMed
Vartiainen, E., Seppala, T., Lillsunde, P., & Puska, P. (2002). Validation of self reported smoking by serum cotinine measurement in a community-based study. Journal of Epidemiology and Community Health, 56(3), 167–170. doi: 10.1136/jech.56.3.167CrossRefGoogle Scholar
Wang, C., Yang, T., Guo, X. F., & Li, D. (2019). The associations of fruit and vegetable intake with lung cancer risk in participants with different smoking status: A meta-analysis of prospective cohort studies. Nutrients, 11, 8. doi: 10.3390/nu11081791CrossRefGoogle ScholarPubMed
Ware, J. E. Jr., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30(6), 473–483.CrossRefGoogle ScholarPubMed
Weinberger, A. H., Pilver, C. E., Desai, R. A., Mazure, C. M., & McKee, S. A. (2013). The relationship of dysthymia, minor depression, and gender to changes in smoking for current and former smokers: Longitudinal evaluation in the U.S. Population. Drug and Alcohol Dependence, 127(1-3), 170–176. doi: 10.1016/j.drugalcdep.2012.06.028CrossRefGoogle ScholarPubMed
World Health Organization. (1967). International Statistical Classification of Diseases, Injuries, and Causes of Death, Eighth Revision. Retrieved from Geneva: https://www.who.int/news-room/spotlight/international-classification-of-diseasesGoogle Scholar
World Health Organization. (2017). Depression and other common mental disorders: Global health estimates. Retrieved from Geneva: https://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdfGoogle Scholar
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