Lung cancer and risk factors for negative emotions in COPD patients with depression: A meta-analysis and systematic review

Objective: To explore the incidence of lung cancer and risk factors for negative emotions in patients with chronic obstructive pulmonary disease (COPD) and depression through systematic reviews and meta-analyses. Methods: Case-control studies, cohort studies, and cross-sectional studies on the incidence of lung cancer and negative emotional risk factors in COPD patients with depression were searched in PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP and other databases. The search was up to October 2024, and Stata 15.1 was used for data analysis. Results: 34 articles were included, with 181,585 people with COPD and depression and 193,882 people with COPD without depression. The results of the meta-analysis showed that the lung cancer incidence rate in COPD patients with depression was 32.6% (95% CI: 0.33–0.45); females [OR = 1.40, 95% CI (1.24, 1.58), p < 0.001], never married [OR = 1.89, 95% CI (1.41, 2.52), p < 0.001], unable to take care of oneself [OR = 1.07, 95% CI (1.05, 1.09), p < 0.001], monthly income <3000 yuan [OR for 1.97, 95% CI for (1.15, 3.38), p = 0.014], smoking [OR for 1.51, 95% CI for (1.28, 1.79), p < 0.001], heart failure [OR for 1.34 , 95% CI (1.31, 1.38), p < 0.001], stroke [OR = 1.59, 95% CI (1.54, 1.64), p < 0.001], out-of-pocket medical expenses [OR = 1.95, 95% CI (1.09, 3.51), p = 0.026], oxygen therapy [OR = 1.67, 95% CI (1.05, 2.64), p = 0.030], and low education level [OR = 1.54, 95% CI (1.17, 2.01), p = 0.002] were risk factors for negative emotions combined with depression in COPD. Conclusion: Based on the available evidence, it was found that 39% of COPD patients have depression, with risk factors including female gender, low income, smoking, heart failure, stroke, and limited self-care ability. Research suggests that depression may be a potential risk factor for lung cancer development among patients with COPD. It may exacerbate the symptoms of COPD and affect immune function, making patients more susceptible to complications such as lung cancer. The clinical significance of this paper is to emphasize the potential impact of depression on lung cancer incidence in patients with COPD and to promote the importance of mental health in the management of chronic diseases. Recommendations for the scientific community, in turn, include further exploration of this mechanism, enhanced mental health screening, and additional clinical studies.