Mood disorders and risk of lung cancer in the EAGLE case-control study and in the U.S. Veterans Affairs inpatient cohort.

Mood disorders may affect lung cancer risk. We evaluated this hypothesis in two large studies.We examined 1,939 lung cancer cases and 2,102 controls from the Environment And Genetics in Lung cancer Etiology (EAGLE) case-control study conducted in Italy (2002-2005), and 82,945 inpatients with a lung cancer diagnosis and 3,586,299 person-years without a lung cancer diagnosis in the U.S. Veterans Affairs Inpatient Cohort (VA study), composed of veterans with a VA hospital admission (1969-1996). In EAGLE, we calculated odds ratios (ORs) and 95% confidence intervals (CI), with extensive adjustment for tobacco smoking and multiple lifestyle factors. In the VA study, we estimated lung cancer relative risks (RRs) and 95% CIs with time-dependent Poisson regression, adjusting for attained age, calendar year, hospital visits, time within the study, and related previous medical diagnoses. In EAGLE, we found decreased lung cancer risk in subjects with a personal history of mood disorders (OR: 0.59, 95% CI: 0.44-0.79, based on 121 lung cancer incident cases and 192 controls) and family history of mood disorders (OR: 0.62, 95% CI: 0.50-0.77, based on 223 lung cancer cases and 345 controls). The VA study analyses yielded similar results (RR: 0.74, 95% CI: 0.71-0.77, based on 2,304 incident lung cancer cases and 177,267 non-cancer person-years) in men with discharge diagnoses for mood disorders. History of mood disorders was associated with nicotine dependence, alcohol and substance use and psychometric scales of depressive and anxiety symptoms in controls for these studies.The consistent finding of a relationship between mood disorders and lung cancer risk across two large studies calls for further research into the complex interplay of risk factors associated with these two widespread and debilitating diseases. Although we adjusted for smoking effects in EAGLE, residual confounding of the results by smoking cannot be ruled out

Relative risks and 95% confidence intervals for lung cancer overall and by other medical conditions in the United States Veterans Affairs Inpatient Cohort: White males (n = 3,669,224) with at least one hospital admission between July 1, 1969 and September 30, 1996.

<p><b>Abbreviations:</b> RR, relative risk; CI, confidence interval; COPD, Chronic Obstructive Pulmonary Disease; ICD, International Classification of Disease.</p>a<p>ICD-8 & ICD-9, code 296 which includes depression and bipolar I disease.</p>b<p>Adjusted for number of visits, age, latency, calendar time, and by the stratifying variables (COPD, alcohol and substance dependence and abuse, and schizophrenia) when appropriate.</p>c<p>Percentage of participants with mood disorders within each medical condition.</p>d<p>ICD-8 & ICD-9, codes 490–492.</p>e<p>ICD-8 & ICD-9, codes 291, 303, 305.0, 535.3, 571.0–571.3, 980.0.</p>f<p>ICD-8 & ICD-9, codes 304–305.</p>g<p>ICD-8 & ICD-9, code 295.</p><p><b>Note:</b> Numbers of participants may not sum to total due to missing data.</p

Numbers and percentages of cases and controls with a first-degree relative (mother, father, siblings, or children) with history of mood disorders by demographic and behavioral characteristics in the EAGLE Study, Italy, 2002–2005.

<p><b>Abbreviation:</b> EAGLE, Environment And Genetics in Lung cancer Etiology.</p>a<p>Median (inter-quartile range).</p>b<p>“Non-educated” subjects are those who did not complete the elementary school.</p><p><b>Note:</b> Numbers of participants may not sum to total due to missing data.</p

Odds ratios (95% confidence intervals) of personal or family history of mood disorders among controls (n = 2,046) by mood symptoms and measures of nicotine dependence, EAGLE Study, Italy, 2002–2005.

<p><b>Abbreviations:</b> OR, odds ratio; CI, confidence interval; NA, not applicable; EAGLE, Environment And Genetics in Lung cancer Etiology.</p>a<p>Adjusted ORs for sex, age, residence, education level, marital status, time-weighted mean alcohol consumption (grams/day), smoking status, years smoking regularly, mean cigarettes per day, years since quitting cigarettes, and the interaction between MD and smoking status.</p>b<p>Center for Epidemiologic Studies – Depression.</p>c<p>Hospital Anxiety & Depression Scale.</p>d<p>Fagerström Test for Nicotine Dependence.</p><p><b>Note:</b> Numbers of participants may not sum to total due to missing data.</p

Numbers and percentages of cases and controls, and risk estimates for lung cancer by categories of personal or family history in the EAGLE Study, Italy, 2002–2005.

<p><b>Abbreviations:</b> OR, odds ratio; CI, confidence interval; EAGLE, Environment And Genetics in Lung cancer Etiology.</p>a<p>Adjusted for sex, age and residence.</p>b<p>Adjusted for sex, age, residence, smoking status, years smoking regularly, mean cigarettes per day, years since quitting cigarettes, time weighted mean alcohol consumption (grams/day), education level and marital status.</p><p><b>Note:</b> Numbers of participants may not sum to total due to missing data.</p

Numbers and percentages of cases and controls with a personal history of mood disorders by demographic and behavioral characteristics in the EAGLE Study, Italy, 2002–2005.

<p><b>Abbreviation:</b> EAGLE, Environment And Genetics in Lung cancer Etiology.</p>a<p>Median (inter-quartile range).</p>b<p>“Non-educated” subjects are those who did not complete the elementary school.</p><p><b>Note:</b> Numbers of participants may not sum to total due to missing data.</p

Relative risks and 95% confidence intervals for lung cancer overall and by period of discharge from the United States Veterans Affairs Inpatient Cohort: White males with at least one hospital admission between July 1, 1969, and September 30, 1996.

<p><b>Abbreviations:</b> RR, relative risk; CI, confidence interval; COPD, Chronic Obstructive Pulmonary Disease; ICD, International Classification of Disease.</p>a<p>ICD-8 & ICD-9, code 296; which includes depression and bipolar disease.</p>b<p>ICD-8 & ICD-9, codes 291, 303, 305.0, 535.3, 571.0–571.3, 980.0.</p>c<p>ICD-8 & ICD-9, codes 304–305.</p>d<p>ICD-8 & ICD-9, codes 490–492.</p>e<p>ICD-8 & ICD-9, code 295.</p><p><b>Note:</b> Numbers of participants may not sum to total due to missing data.</p