No Association between Depression and Risk of Hepatocellular Carcinoma in Older People in Taiwan

Objectives. The objective of this study was to determine whether there is a relationship between depression and risk of hepatocellular carcinoma (HCC) in older people in Taiwan. Methods. A case-control study was conducted to analyze the database from the Taiwan National Health Insurance program. We selected 1815 subjects aged 65 years or older with newly diagnosed HCC as the case group and 7260 subjects without HCC as the comparison group, from 2000 to 2010. Both groups were compared to measure the risk of HCC. Results. After controlling for confounders, the odds ratio of HCC was 0.81 in subjects with depression (95% confidence interval = 0.59, 1.11), as compared with nondepressed subjects. Conclusions. We conclude that no association is detected between depression and risk of hepatocellular carcinoma in older people in Taiwan. 1. Introduction Until now, controversies exist regarding the relationship between depression and subsequent cancer risk. That is, some studies showed an increased risk [1, 2], but others showed no increased risk [3, 4]. Similarly, no specific evidence is available about the relationship between depression and risk of hepatocellular carcinoma (HCC) in older people. In order to explore this issue, a population-based case-control study was conducted to analyze the database from the Taiwan National Health Insurance program. 2. Methods The details of the Taiwan National Health Insurance program can be documented in previous studies [5–7]. In this case-control study, we randomly selected 1815 subjects aged 65 years or older with newly diagnosed HCC as the case group (1132 men and 683 women, mean age 74.31 years, and standard deviation 6.29 years) (according to the International Classification of Diseases 9th Revision-Clinical Modification, ICD-9 codes 155, 155.0, and 155.2) and 7260 subjects without HCC as the comparison group (4528 men and 2732 women, mean age 74.09 years, and standard deviation 6.53 years). Both groups were matched with sex, age, and index year of diagnosing HCC, from 2000 to 2010. The index date was defined as the date of diagnosing HCC. In order to reduce the confounding effects, subjects with any cancer (ICD-9 codes 140–208), major psychiatric diseases (ICD-9 codes 291–293, 294.0, 294.8-294.9, 295, 296.0-296.1, 296.4–296.9, and 297-298), other dementia (290.0–290.4, and 294.1), or mental retardation (ICD-9 codes 317–319) diagnosed before the index date were excluded. Depression (ICD-9 codes 331.0) and other comorbidities potentially associated with HCC were diagnosed before the index date [7]. 3. Results We