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Relationship Between Depression and Pancreatic Cancer in the General Population

From the Departments of Internal Medicine (C.P.C., B.N.D.), Psychiatry (C.P.C., L.J., R.N.), Epidemiology (C.P.C., B.N.D.), Biostatistics (L.J.), University of Iowa College of Medicine and University of Iowa College of Public Health and Iowa City Veterans Affairs Medical Center (B.N.D.), Iowa City, Iowa; and the Department of Biometry and Epidemiology (R.F.W.), Medical University of South Carolina, Charleston, South Carolina.

Address reprint requests to: Caroline Carney, 1-126B MEB/Psychiatry Research, Department of Psychiatry, University of Iowa College of Medicine, Iowa City, IA 52242. Email: caroline-carney{at}uiowa.edu

OBJECTIVE: Prior research suggesting a relationship between pancreatic cancer and depression conducted on clinical populations has been subject to recall bias. We reexamined this association using longitudinal population-based data.

METHODS: This was a retrospective cohort study using longitudinal insurance claims data.

RESULTS: Men with mental disorders were more likely to develop pancreatic cancer than those without psychiatric claims (odds ratio 2.4, confidence interval 1.15–4.78). Depression more commonly preceded pancreatic cancer than it did other gastrointestinal malignancies (odds ratio 4.6, confidence interval 1.07–19.4) or all other cancers (odds ratio 4.1, confidence interval 1.05–16.0).

CONCLUSIONS: Depression and pancreatic cancer are associated in the general population.

Key Words: depression, • mental disorders, • pancreatic cancer, • epidemiology, • claims, • insurance.

Abbreviations: BC/BS = Blue Cross/Blue Shield;; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders;; ICD-9 = International Classification of Diseases-9;; SEER = Surveillance Epidemiology and End Results Cancer Registry;; OR = odds ratio;; CI = confidence interval.

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