抑郁症和糖尿病同时存在与患癌的风险增加有关。本研究旨在调查抑郁症是否进一步增加了糖尿病患者患癌的风险。这项基于台湾国民健康保险索赔数据库的人口匹配队列研究共选取了85,489名新诊断的患有抑郁症的糖尿病患者和427,445名对照对象。匹配过程涉及年龄、性别和糖尿病发病年份。两组的平均随访时间分别为6.4年和6.5年。主要研究结果为总体癌症发生率或特定解剖部位的癌症发生率。 校正的风险比(RR)显示，总体癌症发病率为1.08(95% CI，1.05-1.11)。对于特定部位的癌症，抑郁症与口咽、食管、肝脏、妇科、前列腺、肾脏和血液恶性肿瘤在糖尿病患者中呈显著相关。值得注意的是，观察到了病程反应关系，表明与慢性轻度抑郁或其他未明确抑郁障碍诊断相比，反复发作的重度抑郁发生率更高。此外，与老年人相比，年轻糖尿病患者抑郁和癌症风险之间的相关性更为显著。然而，抗抑郁药物的依从性与癌症风险之间没有明显关系。 本研究的发现表明，抑郁症与糖尿病患者癌症风险增加之间存在显著关联。未来的研究应复制我们的发现，探索药物和非药物治疗对癌症风险的影响，并确定其潜在机制。 ©2023年作者。由约翰威利和爱图书出版的《癌症医学》发表。

The co-occurrence of depression and diabetes mellitus has been linked to an increased risk of developing cancer. This study aimed to investigate whether depression further amplifies the risk of cancer among individuals with diabetes.This population-based matched cohort study utilized Taiwan's National Health Insurance claims database. A total of 85,489 newly diagnosed diabetic patients with depressive disorders were selected, along with 427,445 comparison subjects. The matching process involved age, sex, and the calendar year of diabetes onset. The average follow-up duration for the two cohorts was 6.4 and 6.5 years, respectively. The primary outcome of interest was the occurrence of overall cancer or cancer at specific anatomical sites.The adjusted hazard ratios for overall cancer incidence were 1.08 (95% CI, 1.05-1.11). For site-specific cancers, depression exhibited significant associations with oropharyngeal, esophageal, liver, gynecological, prostate, kidney, and hematologic malignancies among patients with diabetes. Notably, a severity-response relationship was observed, indicating that patients with recurrent episodes of major depressive disorders exhibited a higher incidence of cancer compared to those diagnosed with dysthymia or depressive disorder not otherwise specified. Furthermore, the strength of the association between depression and cancer risk was more pronounced among younger patients with diabetes as opposed to older adults. However, no significant relationship was observed between adherence to antidepressant treatment and cancer risk.The findings of this study indicate a significant association between depression and an elevated risk of cancer among individuals diagnosed with diabetes. Future investigations should replicate our findings, explore the effects of pharmacological and non-pharmacological treatments on cancer risk, and identify the underlying mechanisms.© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.