The link between depression and anxiety status and cancer outcomes has been well-documented but remains unclear. We comprehensively quantified the association between depression and anxiety defined by symptom scales or clinical diagnosis and the risk of cancer incidence, cancer-specific mortality, and all-cause mortality in cancer patients. Pooled estimates of the relative risks (RRs) for cancer incidence and mortality were performed in a meta-analysis by random effects or fixed effects models as appropriate. Associations were tested in subgroups stratified by different study and participant characteristics. Fifty-one eligible cohort studies involving 2,611,907 participants with a mean follow-up period of 10.3 years were identified. Overall, depression and anxiety were associated with a significantly increased risk of cancer incidence (adjusted RR: 1.13, 95% CI: 1.06–1.19), cancer-specific mortality (1.21, 1.16–1.26), and all-cause mortality in cancer patients (1.24, 1.13–1.35). The estimated absolute risk increases (ARIs) associated with depression and anxiety were 34.3 events/100,000 person years (15.8–50.2) for cancer incidence and 28.2 events/100,000 person years (21.5–34.9) for cancer-specific mortality. Subgroup analyses demonstrated that clinically diagnosed depression and anxiety were related to higher cancer incidence, poorer cancer survival, and higher cancer-specific mortality. Psychological distress (symptoms of depression and anxiety) was related to higher cancer-specific mortality and poorer cancer survival but not to increased cancer incidence. Site-specific analyses indicated that overall, depression and anxiety were associated with an increased incidence risks for cancers of the lung, oral cavity, prostate and skin, a higher cancer-specific mortality risk for cancers of the lung, bladder, breast, colorectum, hematopoietic system, kidney and prostate, and an increased all-cause mortality risk in lung cancer patients. These analyses suggest that depression and anxiety may have an etiologic role and prognostic impact on cancer, although there is potential reverse causality; Furthermore, there was substantial heterogeneity among the included studies, and the results should be interpreted with caution. Early detection and effective intervention of depression and anxiety in cancer patients and the general population have public health and clinical importance.

抑郁和焦虑状态与癌症结局之间的联系已得到充分证明，但仍不清楚。我们综合量化了症状量表或临床诊断所定义的抑郁与焦虑之间的关联，以及癌症患者癌症发病率，癌症特异性死亡率和全因死亡率的风险。在荟萃分析中，通过适当的随机效应或固定效应模型对癌症发病率和死亡率的相对风险（RR）进行汇总估计。在按不同研究和参与者特征分层的亚组中对协会进行了测试。确定了51项符合条件的队列研究，涉及2,611,907名参与者，平均随访期10.3年。总体而言，抑郁和焦虑与癌症发生风险显着增加相关（校正后的RR：1.13、95％CI：1.06-1.19），癌症特定死亡率（1.21、1.16-1.26）和癌症患者的全因死亡率（1.24、1.13-1.55）。与抑郁症和焦虑症相关的估计绝对风险增加（ARIs）为34.3事件/ 100,000人年（15.8-50.2），发生癌症的发生率和28.2事件/ 100,000人年（21.5-34.9），发生于癌症的死亡率。亚组分析表明，临床诊断出的抑郁症和焦虑症与更高的癌症发生率，更差的癌症生存率和更高的癌症特异性死亡率有关。心理困扰（抑郁和焦虑症状）与特定于癌症的死亡率较高和癌症生存较弱有关，但与癌症发生率增加无关。特定于站点的分析表明，总体而言，抑郁症和焦虑症与肺癌，口腔癌，前列腺癌和皮肤癌的发病风险增加，与肺癌，膀胱癌，乳腺癌，结肠直肠癌，造血系统，肾脏和前列腺癌的癌症特异性死亡风险增加相关，并且肺癌患者全因死亡风险增加。这些分析表明，尽管存在潜在的逆向因果关系，但抑郁和焦虑对癌症可能具有病因学作用和对预后的影响。此外，纳入研究之间存在很大的异质性，应谨慎解释结果。对癌症患者和普通人群的抑郁症和焦虑症的早期发现和有效干预具有公共卫生和临床重要性。肺癌，膀胱癌，乳腺癌，结肠直肠癌，造血系统癌，肾癌和前列腺癌的特定癌症死亡风险较高，肺癌患者的全因死亡风险较高。这些分析表明，尽管存在潜在的逆向因果关系，但抑郁和焦虑对癌症可能具有病因学作用和对预后的影响。此外，纳入研究之间存在很大的异质性，应谨慎解释结果。对癌症患者和普通人群的抑郁症和焦虑症的早期发现和有效干预具有公共卫生和临床重要性。肺癌，膀胱癌，乳腺癌，结肠直肠癌，造血系统癌，肾癌和前列腺癌的特定癌症死亡风险较高，肺癌患者的全因死亡风险较高。这些分析表明，尽管存在潜在的逆向因果关系，但抑郁和焦虑对癌症可能具有病因学作用和对预后的影响。此外，纳入研究之间存在很大的异质性，应谨慎解释结果。对癌症患者和普通人群的抑郁症和焦虑症的早期发现和有效干预具有公共卫生和临床重要性。这些分析表明，尽管存在潜在的逆向因果关系，但抑郁和焦虑对癌症可能具有病因学作用和对预后的影响。此外，纳入研究之间存在很大的异质性，应谨慎解释结果。对癌症患者和普通人群的抑郁症和焦虑症的早期发现和有效干预具有公共卫生和临床重要性。这些分析表明，尽管存在潜在的逆向因果关系，但抑郁和焦虑对癌症可能具有病因学作用和对预后的影响。此外，纳入研究之间存在很大的异质性，应谨慎解释结果。对癌症患者和普通人群的抑郁症和焦虑症的早期发现和有效干预具有公共卫生和临床重要性。