This cohort study followed 755,079 South Korean adults newly diagnosed with cancer between 2009 and 2013. All had no documented depression before diagnosis, and were followed in national health insurance records through 2023. Depression after diagnosis was coded from ICD-10 and modelled as a time-dependent exposure, with suicide taken from national mortality records. Over a median 13.0 years, 1,926 suicides occurred; incidence was 47.0 per 100,000 person-years with post-diagnosis depression against 17.7 without. The adjusted hazard ratio was 4.76 (95% CI 4.28-5.28), stronger under age 60 and in women. Depression was ascertained from coded diagnoses only, so undiagnosed or untreated cases would be missed.
Why it is interesting: It separates depression arising after a cancer diagnosis from pre-existing depression, and quantifies the suicide gradient. The age and sex interactions point to where risk concentrates among survivors.
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