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1、AbstractBackground:Whetherdepressioncausesincreasedriskofthedevelopmentofbreastcancerhaslongbeendebated.Weconductedanupdatedmeta-analysisofcohortstudiestoassesstheassociationbetweendepressionandriskofbreastcancer.MaterialsandMethods:Relevantliteraturewa
2、ssearchedfromMedline,Embase,WebofScience(uptoApril2014)aswellasmanualsearchesofreferencelistsofselectedpublications.Cohortstudiesontheassociationbetweendepressionandbreastcancerwereincluded.Dataabstractionandqualityassessmentwereconductedindependentlyby
3、twoauthors.Random-effectmodelwasusedtocomputethepooledriskestimate.Visualinspectionofafunnelplot,BeggrankcorrelationtestandEggerlinearregressiontestwereusedtoevaluatethepublicationbias.Results:Weidentifiedelevencohortstudies(182,241participants,2,353cas
4、es)withafollow-updurationrangingfrom5to38years.ThepooledadjustedRRwas1.13(95%CI:0.94to1.36;12=67.2%,/?=0.001).Theassociationbetweentheriskofbreastcanceranddepressionwasconsistentacrosssubgroups.VisualinspectionoffunnelplotandBegg’sandEgger’stestsindicat
5、ednoevidenceofpublicationbias.Regardinglimitations,aone-timeassessmentofdepressionwithnomeasureofdurationweakensthetestofhypothesis.Inaddition,8differentscaleswereusedforthemeasurementofdepression,potentiallyaddingtothemultipleconceptualproblemsconcerne
6、dwiththedefinitionofdepression.Conclusions:Availableepidemiologicalevidenceisinsufficienttosupportapositiveassociationbetweendepressionandbreastcancer.IntroductionDepressionishighlyprevalentinthegeneralpopulation,anditisestimatedthat5.8%ofmenand9.5%ofwo
7、menwillexperienceadepressiveepisodeina12-monthperiod.Thelifetimeincidenceofdepressionhasbeenestimatedatmorethan16%inthegeneralpopulation(WorldHealthOrganization,2001;Kessleretal.,2003;WorldHealthOrganization,2008).Breastcancerisbyfarthemostcommomcanceri
8、nwomen(InternationalAgencyforResearchonCancer,2008),theglobalburdenofbreastcancermeasuredbyincidenceandmortalityissubstantialandontheincrease(Bensonetal”2012).Thereareanestimated1.5millioncasesdiagnosedannuallyandalmost0.5million
