Abstract
BackgroundMood disorders may affect lung cancer risk. We evaluated this hypothesis in two large studies.Methodology/Principal FindingsWe examined 1,939 lung cancer cases and 2,102 controls from the Environment And Genetics in Lung cancer Etiology (EAGLE) case-control study conducted in Italy (2002–2005), and 82,945 inpatients with a lung cancer diagnosis and 3,586,299 person-years without a lung cancer diagnosis in the U.S. Veterans Affairs Inpatient Cohort (VA study), composed of veterans with a VA hospital admission (1969–1996). In EAGLE, we calculated odds ratios (ORs) and 95% confidence intervals (CI), with extensive adjustment for tobacco smoking and multiple lifestyle factors. In the VA study, we estimated lung cancer relative risks (RRs) and 95% CIs with time-dependent Poisson regression, adjusting for attained age, calendar year, hospital visits, time within the study, and related previous medical diagnoses. In EAGLE, we found decreased lung cancer risk in subjects with a personal history of mood disorders (OR: 0.59, 95% CI: 0.44–0.79, based on 121 lung cancer incident cases and 192 controls) and family history of mood disorders (OR: 0.62, 95% CI: 0.50–0.77, based on 223 lung cancer cases and 345 controls). The VA study analyses yielded similar results (RR: 0.74, 95% CI: 0.71–0.77, based on 2,304 incident lung cancer cases and 177,267 non-cancer person-years) in men with discharge diagnoses for mood disorders. History of mood disorders was associated with nicotine dependence, alcohol and substance use and psychometric scales of depressive and anxiety symptoms in controls for these studies.Conclusions/SignificanceThe consistent finding of a relationship between mood disorders and lung cancer risk across two large studies calls for further research into the complex interplay of risk factors associated with these two widespread and debilitating diseases. Although we adjusted for smoking effects in EAGLE, residual confounding of the results by smoking cannot be ruled out.
Highlights
Tobacco smoking, and other environmental and genetic factors have all been implicated in lung cancer etiology [1]
In order to examine the relations between mood disorders and lung cancer, we investigated the association between them in two large studies: the Environment And Genetics in Lung cancer Etiology (EAGLE) study from the Lombardy region of Italy [18] and the U.S Veterans Affairs Inpatient Cohort Study (VA study), including over 3.6 million adult White veteran men [19]
Subjects with a family history of mood disorders, cases with no education, current smoker cases and never smoker controls were more likely to have a personal history of mood disorders
Summary
Other environmental and genetic factors have all been implicated in lung cancer etiology [1]. Psychiatric conditions have been hypothesized to have a relationship to lung cancer risk, but the association is controversial [2,3]. Genetic or pharmacological, have been proposed for the consistent positive bidirectional associations between depression and smoking [6,7]. A common genetic predisposition to both mood disorders and cancer has been proposed [8]. Mood disorders may affect lung cancer risk. We evaluated this hypothesis in two large studies
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