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עמוד בית
Tue, 28.05.24

ORIGINAL ARTICLES

IMAJ | volume 25

Journal 7, July 2023
pages: 490-494

The Association Between Depression and Invasive and In-situ Cervical Tumors: A Large Population Based Cohort Study

1 Israel Center for Disease Control, Ministry of Health, Sheba Medical Center, Tel Hashomer, Israel 2 Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel 3 Maccabi Institute for Research and Innovation, Tel Aviv, Israel 4 Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel 5 Maccabi Healthcare Services, Tel Aviv, Israel 6 Women Health Center, Maccabi Healthcare Services, Tel Aviv, Israel

Summary

Background:

Depression has been shown to be associated with cervical tumors (CTs), an association mostly demonstrated in studies in which temporality could not have been ascertained.

Objectives:

To study the association between depression and CTs and the influence of co-morbidities of this association in a large cohort study.

Methods:

A retrospective computer-based cohort study was conducted. The cohort included 357,450 female members of Maccabi Healthcare Services. The cohort was classified as depressed or non-depressed using the International Classification of Diseases 9/10 codes. For each subgroup, demographic characteristics, behavioral characteristics, co-morbidities, and CTs diagnosis were obtained. The burden of co-morbidities was defined as the sum of major co-morbidities. We used zero-inflated negative binomial regression analysis due to over-dispersion to estimate the relative risk (RR) for CTs with 95% confidence interval (95%CI).

Results:

Depression was diagnosed in 15,789 women. Among this group, CTs were diagnosed in 1585 (10.0%). Among the 341,661 non-depressed, CTs were diagnosed in 4185 (1.2%). After adjustment to age and socioeconomic status, the association between depression and CTs was RR=9.2 (95%CI 8.7–9.9, P-value < 0.0001). The association between depression and CTs increased as the burden of clinical conditions increased (P-value < 0.0001).

Conclusions:

Women with depression are at a higher risk for CTs, especially among those who have several co-morbidities. Tighter gynecology surveillance is crucial among these women.

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