The effect of depressive symptoms on the risk of cancer in middle-aged and elderly Chinese—a cross-sectional survey

Background: Cancer has been the leading cause of death in China since 2010. While the prevalence of depression among Chinese adults was 20% from 2011 to 2019. China is home to 1/5 of the world’s elderly people so healthy ageing is important. However, the association between depressive symptoms and cancer risk remains unclear, and there is a lack of empirical data on middle-aged and elderly Chinese. Therefore, we explored the impact of depressive symptoms on cancer risk in middle-aged and elderly Chinese, to provide data support and decision-making basis for health management of middle-aged and elderly Chinese. Methods: Data were collected from the China Health and Retirement Longitudinal Study 2020(BECPU: IRB00001052-11015). Inclusion criteria: middle-aged and elderly people aged 45 years and above. Exclusion criteria: data on depressive symptoms or prevalence of malignant tumors were missing. We used the Center for Epidemiologic Studies Depression Scale to measure depressive symptoms. A score of 10 or more is considered to indicate depressive symptoms. Cancer in this study refers to the malignant tumors included in the CHARLS 2020 survey. Pearson chi-square test and binary logistic regression were used to investigate the effect of depressive symptoms on the risk of cancer in middle-aged and elderly Chinese. Findings: A total of 16,057 individuals were included in this study, with an average age of 62.4 (±10.5) years and a male to female ratio of 1:1.09. The prevalence of depressive symptoms was 37.6% and the prevalence of cancer was 2.2%. Multiple control variables were included to adjust the binary logistic regression models. Model 1 was adjusted for basic characteristics (gender, age, region, urban-rural category of residence, education, and retirement). Model 2 was adjusted for behavioral habits (smoking and drinking) on the basis of model 1. Model 3 was adjusted for health status (chronic diseases and activities of daily living) on the basis of model 2. The results showed that depressive symptoms (Model 1: OR 1.514, 95% CI 1.217-1.884, p<0.001; Model 2: OR 1.328, 95% CI 1.058-1.666, p=0.014; Model 3: OR 1.298, 95% CI 1.035-1.628, p=0.021) were a risk factor for cancer in middle-aged and elderly Chinese. Interpretation: Depressive symptoms were a risk factor for cancer in middle-aged and elderly Chinese. They need to keep a good mood for maintaining good health and preventing cancer because psychological health and well-being have important implications for individual and societal thriving. Limitations: this study is a cross-sectional study and cannot reflect the progression of cancer. Strengths: it provided data support for Chinese health management and was conducive to promoting the healthy aging in China. Funding: NSFCYCP(71904142).