title: Do depressive symptoms predict cancer incidence?: 17-year follow-up of the Whitehall II study.
abstract: OBJECTIVE
  To explore the association between depressive symptom history and cancer incidence.
  
  
  METHODS
  Affective/emotional depressive symptoms were assessed using the General Health Questionnaire (GHQ-30) depression sub-scale across phase 1 (1985-1988), phase 2 (1989-1990), and phase 3 (1991-1994) of the Whitehall II prospective cohort study; 'chronic'=depressive episode at phase 1, 2 and 3; 'new'=depressive episode at phase 3 only. Cancer incidence was obtained from the National Health Service Central Register with an average follow-up of 15.6 years (range 0.08-17.4). The study sample consisted of 6983 participants, aged 35-55 years at baseline. Results were adjusted for age, sex, socio-economic position, health behaviours, health status/conditions, medication, and social support.
  
  
  RESULTS
  Over a 17.4 year follow-up, chronic depressive symptoms did not increase the risk of cancer incidence compared to those who never experienced symptoms (hazard ratio (HR)=1.03, 95% confidence interval (CI): 0.71-1.49). Participants who experienced new depressive symptoms had an increased risk of cancer incidence in the first 9 years of follow-up (HR=1.89, 95% CI: 1.23-2.90) but no increased risk in later years (HR=0.84, 95% CI: 0.52-1.35).
  
  
  CONCLUSIONS
  Chronic depressive symptoms were not associated with cancer incidence. In contrast, new-onset symptoms were associated with a substantially increased risk, possibly due to reverse causality.
authors: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, WC1E 7HB London, UK. Electronic address: g.archer.11@ucl.ac.uk.
authors: Gemma
authors: G
authors: Archer
authors: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, WC1E 7HB London, UK.
authors: Hynek
authors: H
authors: Pikhart
authors: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, WC1E 7HB London, UK.
authors: Jenny
authors: J
authors: Head
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003863:Depression / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016019:Survival Analysis
keywords: Cancer; Depression; Depressive symptoms; Longitudinal studies; Psycho-oncology