Depressive symptoms and incident cancer risk in middle-aged and older Chinese adults - Findings from CHARLS

Sep 23, 2026

Uploaded by Adam

Observational analysis examining how depressive symptoms relate to developing incident cancer in middle-aged and older Chinese adults. Data from the 2015–2020 China Health and Retirement Longitudinal Study (CHARLS) include 13,132 cancer-free participants aged 45+ (median age 60; 46.9% male). Depressive symptoms were measured at baseline with CESD-10, and incident cancer was ascertained via self-reported physician diagnoses during follow-up. Cox models adjusting for sociodemographic, lifestyle, and health factors show a non-significant 19.3% higher cancer risk for clinically significant depression (HR 1.193, 95% CI 0.905–1.572; P = .210). The association persisted by severity categories, supporting the value of mental health screening in cancer prevention strategies.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Introduction

Depression, cancer, and prior risk factors

Study objective and rationale

Methods

Data source and cohort

Depression and cancer assessment

Statistical analysis (Cox models)

Results

Baseline characteristics and incident cancer cases

Adjusted association between depression and cancer risk

Severity-based analyses

® Observational Study Depressive symptoms and incident cancer risk in middle-aged and older Chinese adults Findings from CHARLS Yuanjing Zhao, BSa , Lei Zhou, MDa , Qiuzi Sun, MSb , Lexia Lei, MSa , Ye Zhang, BSa , Cuiya Tang, BSa , Huachun Zhang, BSb , Maoying Guan, MDa ,* | Abstract
Depression and cancer are major public health concerns worldwide, particularly among aging populations. This study aims to investigate the association between depressive symptoms and incident cancer among middle-aged and older Chinese adults. We analyzed data from the 2015 to 2020 China Health and Retirement Longitudinal Study, a nationally representative cohort of Chinese adults aged 45 and older. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale at baseline. Incident cancer cases were identified through self-reported physician diagnoses during follow-up waves. Cox proportional hazard models were used to estimate the association between baseline depressive symptoms and subsequent cancer incidence, adjusting for sociodemographic factors, lifestyles, and health status. Among 13,132 participants (median age = 60 years, 46.9% male) without a history of cancer at baseline, 250 new cancer cases were identified over a median follow-up of 5.0 years. After adjusting for potential confounders, individuals with clinically significant depressive symptoms (10-item Center for Epidemiologic Studies Depression Scale score ≥10) had a 19.3% higher risk of developing cancer compared to those without (hazard ratio = 1. 193, 95% confidence interval = 0.905–1.572, P = .210) . This association persisted when categorized by the severity of depressive symptoms. Our findings suggest that depressive symptoms showed a nonsignificant trend toward increased risk of incident cancer in middle-aged and older Chinese adults. This underscores the importance of mental health screening and intervention in this population, potentially as part of a comprehensive strategy for cancer prevention. Further research is needed to elucidate the underlying mechanisms and to develop targeted interventions.
Abbreviations: CESD-10 = 10-item Center for Epidemiologic Studies Depression Scale, CHARLS = China Health and Retirement Longitudinal Study, CI = confidence interval, HR = hazard ratio. | | --- | | Keywords: cancer, CHARLS, Chinese, depressive symptom | 1. Introduction Cancer is one of the leading causes of death worldwide, and its incidence and mortality rates have continued to rise over the past decades. [1] In China, cancer has become the second leading cause of death after cardiovascular diseases. [2] Previous studies have shown that lifestyle factors such as smoking, alcohol consumption, and physical inactivity, as well as chronic diseases such as type 2 diabetes mellitus, hypertension, and renal disease, may increase the risk of cancer in individuals. [3–5] However, increasing evidence suggests that psychological factors may also play an important role in cancer development and prognosis. [6,7] Depression is a common psychiatric disorder, the main features of which include persistent low mood, reduced interest, and decreased vigor.[8] Unlike transient mood swings, depression may have widespread and long-lasting negative effects on an individual’s physiological functioning. [9] A growing number of studies have found an association between depressive symptoms and the development of malignant tumors. [10–12] A meta-analysis This study was supported by Shanghai Clinical Medical Research Center of Chinese Medicine and Tumor (21MC1930500), Shanghai Municipal Health Commission Scientific Research Project (20244Y0111), National Medical Center Clinical Research Project, Longhua Hospital of Shanghai University of Traditional Chinese Medicine (GFB2401-1-1), Shanghai New Three-Year Action Plan Research Project (2025–2027; GFB2502), National Medical Center Clinical Research Project, National Administration of Traditiona

FAQs

What is the study’s main aim?

To assess whether baseline depressive symptoms are associated with incident cancer risk among middle-aged and older Chinese adults using CHARLS data.

How were depressive symptoms measured in this study?

Depressive symptoms were measured at baseline with the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10).

What did the study find about cancer risk?

Clinically significant depressive symptoms (CESD-10 score ≥10) showed a 19.3% higher cancer risk compared with no clinically significant symptoms, but the association was not statistically significant (HR 1.193, 95% CI 0.905–1.572; P = .210).

Sep 23, 2026

Uploaded by Adam