Lower risk of depression after smoking cessation and alcohol abstinence in patients with gastric cancer who underwent gastrectomy: A population-based nationwide cohort study.

Abstract

314 Background: Although depression is associated with poor treatment outcomes and lower quality of life in cancer patients, little is known about whether lifestyle modifications could help prevent depression in these patients. This study aimed to identify the effect of lifestyle modifications such as smoking cessation, alcohol abstinence, and starting exercise on depression development in gastric cancer patients who underwent gastrectomy. Methods: Using the Korean National Health Insurance Service database, we identified gastric cancer patients who underwent gastrectomy between 2010 and 2017. Self-reported lifestyle behaviors within two years before and after gastrectomy were analyzed using health examination database. We classified the patients according to changes in lifestyle behaviors and compared their risk of developing depression. Results: Among 18,902 patients who underwent gastrectomy, 2,302 (12.19%) developed depression (26.00 per 1000 person-years). Smoking cessation (Hazard ratio (HR) = 0.77, 95% confidence interval (CI): 0.66-0.91) and alcohol abstinence (HR = 0.79, 95% CI: 0.69-0.90) were associated with reduced risk of depression development compared to persistent smoking and persistent drinking, respectively. Starting exercise was not associated with risk of depression. When lifestyle behaviors after gastrectomy were scored from 0 to 3 points (one point each for not smoking, not drinking, and being physically active), the risk of depression showed a decreasing tendency as lifestyle scores increased from 0 (reference) to 1 (HR = 0.69, 95% CI: 0.55-0.83), 2 (HR = 0.60, 95% CI: 0.50-0.76), and 3 (HR = 0.55, 95% CI: 0.45-0.68) points. Conclusions: Smoking cessation and alcohol abstinence can reduce the risk of depression in gastric cancer patients who undergo gastrectomy. [Table: see text]