Abstract 6230: Meta-analysis with a total of 4,978,125 cancer patients reveals depression as a major mortality risk factor

Abstract Background: Depression is a prevalent comorbidity in cancer patients, potentially affecting their quality of life, treatment adherence, and biological processes such as immune function and inflammation. Evidence suggests that depression may contribute to poorer outcomes. The objective of our study was to identify studies examining the association between depression and the risk of cancer-specific mortality as well as all-cause mortality in cancer patients. Methods: A comprehensive search of online databases was conducted for studies published up to October 1, 2024. Only cohort studies that assessed clinical depression using established diagnostic criteria and reported risk estimates for mortality (such as relative risk, hazard ratio, or odds ratio) were included. A random-effects model was used for statistical analysis, and heterogeneity was assessed using Cochran's Q and the I2 statistic. The analysis was further refined by conducting cancer-type specific analyses for the most common cancers, including lung, breast, colorectal, and prostate cancers. Statistical analysis was performed using www.metaanalysisonline.com web platform. Results: After screening of 9, 306 studies, we included 65 studies with a total of 4, 978, 125 patients. In these studies, depression was associated with increased cancer mortality in each of the major cancer types. In colorectal cancer, the hazard ratio (HR) was 1.83, 95% CI: 1.47-2.28, indicating an 83% higher risk, while breast cancer showed a 23% higher risk (95%CI: 1.13-1.34). Lung cancer patients had a 59% higher risk (95%CI: 1.36-1.86), and prostate cancer patients faced a 74% higher risk (95%CI: 1.36-2.23). In mixed cancer types, depression was linked to a 38% higher mortality risk (95%CI: 1.20-1.60). Z-score analysis proved sufficient case number to draw a definitive conclusion in each of the sub-cohorts. Conclusions: Our results suggest that the presence of depression is significantly associated with 23%-83% increase of cancer-specific mortality across various cancer types, including colorectal, breast, lung, and prostate cancers. Citation Format: Janos Tibor Fekete, Zoltan Ungvari, Monika Fekete, Balazs Gyorffy. Meta-analysis with a total of 4, 978, 125 cancer patients reveals depression as a major mortality risk factor [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 6230.