Depression as a Risk Factor for Gynecological Cancers: Evidence from NHANES Data

Purpose: Depression is one of the leading sources of disease burden globally and plays a significant role in the occurrence and development of many cancers, representing an important health risk. However, the relationship between depression and the risk of gynecologic cancers has not been fully assessed. This study aims to explore the association between depression and the risk of gynecologic cancers. Patients and Methods: We selected 11,574 participants from the NHANES 2009-2018 cycles, among which 274 had gynecologic cancer (GC), 137 had cervical cancer (CC), 48 had ovarian cancer (OC), and 89 had endometrial cancer (EC). Box plots were used to assess the differences in PHQ-9 depression scores between cancer and non-cancer groups. Logistic regression models and restricted cubic spline (RCS) models were employed to evaluate the relationship between PHQ-9 scores and gynecologic cancers. Subgroup analyses and interaction tests examined the consistency of the association across different characteristics. Results: There was a significant difference in PHQ-9 scores between the cancer group and the non-cancer group. In the multivariable logistic regression analysis, PHQ-9 scores were positively correlated with GC, OC, and EC, while no significant association was found with CC risk. Additionally, the RCS model also indicated no nonlinear association between PHQ-9 scores and CC risk. Additionally, subgroup analyses suggested that the relationship between PHQ-9 scores and CC and OC was consistent across groups, whereas the association between PHQ-9 scores and GC and EC showed heterogeneity in relation to race and marital status. Conclusion: Depression is positively correlated with gynecologic cancers. Specifically, higher levels of depression are associated with an increased risk of OC and EC, while no significant association was found with CC risk. Future attention should be given to the impact of depression on the incidence of gynecologic cancers, particularly OC and EC.