Depression and risk of epithelial ovarian cancer: Results from two large prospective cohort studies

doi:10.1016/j.ygyno.2015.10.004

. 2015 Dec;139(3):481-6.

doi: 10.1016/j.ygyno.2015.10.004. Epub 2015 Oct 9.

Depression and risk of epithelial ovarian cancer: Results from two large prospective cohort studies

Tianyi Huang¹, Elizabeth M Poole², Olivia I Okereke³, Laura D Kubzansky⁴, A Heather Eliassen⁵, Anil K Sood⁶, Molin Wang⁷, Shelley S Tworoger⁵

Affiliations

¹ Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States. Electronic address: tih541@mail.harvard.edu.
² Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
³ Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
⁴ Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
⁵ Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
⁶ Department of Gynecologic Oncology, MD Anderson Cancer Center, Houston, TX, United States.
⁷ Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States.

PMID: 26449316
PMCID: PMC4679423
DOI: 10.1016/j.ygyno.2015.10.004

Depression and risk of epithelial ovarian cancer: Results from two large prospective cohort studies

Tianyi Huang et al. Gynecol Oncol. 2015 Dec.

. 2015 Dec;139(3):481-6.

doi: 10.1016/j.ygyno.2015.10.004. Epub 2015 Oct 9.

Authors

Tianyi Huang¹, Elizabeth M Poole², Olivia I Okereke³, Laura D Kubzansky⁴, A Heather Eliassen⁵, Anil K Sood⁶, Molin Wang⁷, Shelley S Tworoger⁵

Affiliations

¹ Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States. Electronic address: tih541@mail.harvard.edu.
² Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
³ Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
⁴ Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
⁵ Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
⁶ Department of Gynecologic Oncology, MD Anderson Cancer Center, Houston, TX, United States.
⁷ Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States.

PMID: 26449316
PMCID: PMC4679423
DOI: 10.1016/j.ygyno.2015.10.004

Abstract

Objectives: While emerging evidence supports a possible link between depression and ovarian cancer progression, no prospective studies have explored the association with ovarian cancer risk.

Methods: We prospectively followed 77,451 women from the Nurses' Health Study (1992-2010) and 106,452 women from the Nurses' Health Study II (1993-2011). Depression was defined as having one or more of the following: a 5-item Mental Health Index (MHI-5) score≤52, antidepressant use, or physician-diagnosed depression. Multivariable-adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between depression and incident ovarian cancer.

Results: We documented 698 incident cases of epithelial ovarian cancer during follow-up. In multivariable analyses, depression assessed 2-4years before cancer diagnosis was associated with a modestly higher incidence of ovarian cancer (HR=1.30, 95% CI 1.05-1.60). Compared to women with persistent negative depression status, the adjusted HRs were 1.34 (95% CI 1.01-1.76) for women with persistent positive depression status and 1.28 (95% CI 0.88-1.85) for women with worsening depression status over follow-up. The association did not appear to vary by ovarian cancer risk factors or tumor characteristics.

Conclusions: Our findings suggest that depression may be associated with a modestly increased risk of ovarian cancer. Given the relatively high prevalence of depression in women, future work in larger prospective human studies is needed to confirm our results.

Keywords: Chronic stress; Depression; Etiology; Latency period; Ovarian cancer; Repeated measures.

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References

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1. Gross AL, Gallo JJ, Eaton WW. Depression and cancer risk: 24 years of follow-up of the Baltimore Epidemiologic Catchment Area sample. Cancer causes & control : CCC. 2010;21:191–9. - PMC - PubMed

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[1] Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B. Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet. 2007;370:851–8. - PubMed

[2] Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B. Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet. 2007;370:851–8. - PubMed

[3] Howren MB, Lamkin DM, Suls J. Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosom Med. 2009;71:171–86. - PubMed

[4] Howren MB, Lamkin DM, Suls J. Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosom Med. 2009;71:171–86. - PubMed

[5] Luppino FS, de Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BW, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Archives of general psychiatry. 2010;67:220–9. - PubMed

[6] Luppino FS, de Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BW, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Archives of general psychiatry. 2010;67:220–9. - PubMed

[7] Penninx BW, Guralnik JM, Pahor M, Ferrucci L, Cerhan JR, Wallace RB, et al. Chronically depressed mood and cancer risk in older persons. Journal of the National Cancer Institute. 1998;90:1888–93. - PubMed

[8] Penninx BW, Guralnik JM, Pahor M, Ferrucci L, Cerhan JR, Wallace RB, et al. Chronically depressed mood and cancer risk in older persons. Journal of the National Cancer Institute. 1998;90:1888–93. - PubMed

[9] Gross AL, Gallo JJ, Eaton WW. Depression and cancer risk: 24 years of follow-up of the Baltimore Epidemiologic Catchment Area sample. Cancer causes & control : CCC. 2010;21:191–9. - PMC - PubMed

[10] Gross AL, Gallo JJ, Eaton WW. Depression and cancer risk: 24 years of follow-up of the Baltimore Epidemiologic Catchment Area sample. Cancer causes & control : CCC. 2010;21:191–9. - PMC - PubMed

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Depression and risk of epithelial ovarian cancer: Results from two large prospective cohort studies

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Depression and risk of epithelial ovarian cancer: Results from two large prospective cohort studies

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