Long-term risk of depression in lung, colon, breast, and prostate cancer: a 25-year nationwide comparative study.

BACKGROUND: Depression is common among patients with cancer, but its occurrence may vary across cancer types with differing prognoses and symptom burdens. This nationwide study examined the long-term development of depression among patients with lung, colon, breast, and prostate cancer. METHODS: Using Danish health registries (1998–2022), we identified all individuals with a first diagnosis of lung, colon, breast, or prostate cancer. Depression was assessed through hospital-based diagnoses or antidepressant prescriptions (≥ 2 dispensations within two years after diagnosis). Logistic regression models estimated odds ratios (ORs) for antidepressant initiation among cancer types, adjusted for age, marital status, municipality, educational attainment, and comorbidity (Quan adaptation of the Charlson Comorbidity Index). RESULTS: The study included more than 280,000 patients with cancer. Antidepressant use before diagnosis was more frequent among lung cancer compared with colon, breast, and prostate cancer. Following diagnosis, 1-year antidepressant use reached 16.8% in men and 24.9% in women with lung cancer, approximately twice the corresponding rates in other cancers. Adjusted analyses confirmed, that patients with lung cancer were more likely to initiate antidepressant therapy than those with colon, breast, or prostate cancer (adjusted ORs 1.9–2.5, p < 0.001). Depression diagnoses showed a similar, though less pronounced, pattern. CONCLUSIONS: Patients with lung cancer exhibit a substantially higher long-term risk of depression – even after adjustment compared to colon, breast, and prostate cancer - both before and after cancer diagnosis.