Risk factors for developing depression in women with cervical cancer: a nationwide population-based study in Taiwan

Figures & data

Table 1 Baseline characteristics of patients with and without cervical cancer

Demographic data	Patients with cervical cancer (n=19,316)		Matched cohort (n=19,316)		P-value
	N	%	N	%
Age, years (interquartile range)	55.16 (44–66)		55.16 (44–66)		1.000
≥65	5,278	27.3	5,278	27.3	1.000
<65	14,038	72.7	14,038	72.7	1.000
Sex
Female	19,316	100.0	19,316	100.0	1.000
Comorbidities
Diabetes mellitus	3,137	16.2	3,136	16.2	1.000
Hypertension	5,967	30.9	5,969	30.9	0.982
Congestive heart failure	1,105	5.7	1,103	5.7	0.983
COPD	2,359	12.2	2,360	12.2	1.000
Chronic kidney disease	1,616	8.4	1,614	8.4	0.985
Cirrhosis	221	1.1	200	1.0	0.327
Autoimmune disease	1,020	5.3	1,020	5.3	1.000
Cerebrovascular disease	1,596	8.3	1,594	8.3	0.971
Ischemic heart disease	2,650	13.7	2,650	13.7	1.000
Follow-up years, median (interquartile range)	5.23 (1.75–8.48)		6.44 (3.44–9.56)		<0.001

Table 2 Incidence of depression occurrence among patients with and without cervical cancera

	Patients with cervical cancer		Matched cohort		Risk ratio (95% CI)	P-value
	Number of events	Per 1,000 person-years	Number of events	Per 1,000 person-years
Total	813	8.1	744	6.0	1.35 (1.22–1.49)	<0.0001
Age
≥65	237	10.1	239	7.7	1.32 (1.10–1.58)	0.0026
<65	576	7.4	505	5.4	1.37 (1.22–1.55)	<0.0001

Note:

a Adjusted for age, sex, diabetes mellitus, hypertension, dyslipidemia, congestive heart failure, chronic obstructive pulmonary disease, chronic kidney disease, cirrhosis, autoimmune diseases, cerebrovascular disease, and ischemic heart disease.

Table 3 Analyses of risk factors for depression among patients with and without cervical cancer

Predictive variables	Univariate analysis		Multivariate analysisa
	HR (95% CI)	P-value	HR (95% CI)	P-value
Cervical cancerb	1.35 (1.22–1.49)	<0.001	1.36 (1.23–1.50)	<0.001
Age ≥65 (≥65=1, <65=0)	1.38 (1.24–1.54)	<0.001	1.15 (1.02–1.30)	0.027
Comorbidities
Diabetes mellitus	1.41 (1.24–1.61)	<0.001	1.16 (1.00–1.33)	0.043
Hypertension	1.37 (1.24–1.53)	<0.001	1.07 (0.94–1.22)	0.317
Congestive heart failure	1.69 (1.38–2.06)	<0.001	1.20 (0.97–1.50)	0.098
COPD	1.23 (1.06–1.43)	0.006	0.99 (0.85–1.16)	0.902
Chronic kidney disease	1.34 (1.12–1.60)	0.002	1.10 (0.91–1.33)	0.323
Cirrhosis	1.69 (1.06–2.69)	0.027	1.46 (0.92–2.33)	0.112
Autoimmune disease	1.28 (1.03–1.59)	0.026	1.11 (0.89–1.39)	0.337
Cerebrovascular disease	1.69 (1.44–2.00)	<0.001	1.34 (1.13–1.60)	<0.001
Ischemic heart disease	1.61 (1.41–1.83)	<0.001	1.27 (1.09–1.48)	0.002

Notes:

a All factors with P<0.1 in the univariate analyses were included in the Cox multivariate analysis.

b Treatment was analyzed as a time-dependent covariate in the Cox regression model.

Table 4 Analyses of risk factors for depression among patients with cervical cancer

Predictive variables	Univariate analysis		Multivariate analysisa
	HR (95% CI)	P-value	HR (95% CI)	P-value
Age ≥65 (≥65=1, <65=0)	1.35 (1.16–1.57)	<0.0001	1.12 (0.94–1.34)	0.204
Comorbidities
Diabetes mellitus	1.48 (1.24–1.77)	<0.0001	1.28 (1.05–1.55)	0.013
Hypertension	1.30 (1.12–1.50)	<0.0001	1.00 (0.83–1.19)	0.958
Congestive heart failure	1.95 (1.50–2.53)	<0.0001	1.55 (1.16–2.07)	0.003
COPD	1.16 (0.94–1.43)	0.178
Chronic kidney disease	1.36 (1.05–1.75)	0.019	1.11 (0.85–1.45)	0.447
Cirrhosis	1.66 (0.86–3.21)	0.130
Autoimmune disease	1.12 (0.81–1.54)	0.495
Cerebrovascular disease	1.65 (1.31–2.08)	<0.0001	1.34 (0.34–1.02)	0.022
Ischemic heart disease	1.41 (1.17–1.71)	<0.0001	1.07 (0.86–1.33)	0.554
Treatmentsb
Surgery alone	0.77 (0.67–0.90)	<0.001	0.87 (0.73–1.05)	0.143
Surgery with neoadjuvant and/or adjuvant chemoradiotherapy	1.16 (1.01–1.34)	0.043	1.12 (0.94–1.33)	0.206
Chemoradiotherapy without surgery	1.08 (0.92–1.26)	0.351

Notes:

a All factors with P<0.1 in the univariate analyses were included in the Cox multivariate analysis.

b Treatment was analyzed as a time-dependent covariate in the Cox regression model.