title: Vital exhaustion and risk for cancer: a prospective cohort study on the association between depressive feelings, fatigue, and risk of cancer.
abstract: BACKGROUND
  Vital exhaustion, defined as feelings of depression and fatigue, has previously been investigated mainly as a risk factor for cardiovascular disease. The authors investigated the association between depressive feelings and fatigue as covered by the concept of vital exhaustion and the risk for cancer.
  
  
  METHODS
  The sample consisted of 8527 persons aged 21-94 who had been examined in 1991-1994 within the Copenhagen City Heart Study. For the analysis, the sample was divided into quartiles on the basis of vital exhaustion scores. Cancer cases were ascertained by linkage to the Danish Cancer Registry. The mean length of follow-up was 8.6 years. Regression analyses for etiology-based groups of cancer sites were conducted on the basis of the Cox proportional hazards model, with adjustment for a number of confounding variables.
  
  
  RESULTS
  Cancer was diagnosed in 976 persons (12%) during follow-up. In comparison to those with the lowest scores, persons with the highest vital exhaustion scores had a significantly decreased risk for developing cancer at all sites (hazard ratio [HR], 0.80; 95% confidence interval [CI}, 0.66-0.96), smoking-related cancers (HR, 0.64; 95% CI, 0.46-0.90), and virus and immune-related cancers (HR, 0.51; 95% CI, 0.26-0.99). No significant change in risk was found for cancers related to alcohol consumption or hormones.
  
  
  CONCLUSIONS
  The results did not support the hypothesis that symptoms of fatigue and depression, as ascertained in the vital exhaustion index, increased the risk for cancer.
authors.affiliation: Danish Cancer Society, Institute of Cancer Epidemiology, Copenhagen.
authors.forename: Corinna
authors.initials: C
authors.lastname: Bergelt
authors.forename: Jane
authors.initials: J
authors.lastname: Christensen
authors.forename: Eva
authors.initials: E
authors.lastname: Prescott
authors.forename: Morten
authors.initials: M
authors.lastname: Grønbaek
authors.forename: Uwe
authors.initials: U
authors.lastname: Koch
authors.forename: Christoffer
authors.initials: C
authors.lastname: Johansen
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003863:Depression / Q000150:complications*; D005221:Fatigue / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D009369:Neoplasms / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires