Abstract: Objective The aim of this study was to reveal the association characteristics between cancer and depression using the data from community-based multi-morbidity study in rural China(COMMON),and provide a scientific basis for early prevention and intervention of depression in cancer patients. Methods We collected questionnaire responses,physical examination records,health insurance data,and electronic medical records from both cancer and non-cancer participants.Using propensity score matching at a 1∶4 ratio,we balanced baseline characteristics between the cancer and control groups.We then compared the prevalence of depression between these groups,as well as across subgroups stratified by age,sex,income,and other factors.The association between cancer and depression risk was assessed using univariate and multivariate logistic regression.Finally,we conducted sensitivity analyses by restricting the regression models to participants with mild-to-severe depression. Results After matching the baseline characteristics,a total of 206 cancer patients and 824 controls were included in the study,and all baseline characteristics between the two groups.Among all individuals,women,participants under 60 years old and those from low-income families(10,000-34,999 Yuan per year),the cancer group had a higher prevalence of depression than the non-cancer group(P＜0.05),no difference was found in other subgroup(P＞0.05).The results of multivariate logistic regression analysis showed that cancer was an independent risk factor for depression,and the risk of depression in cancer patients was 2.38 times that of participants without cancer(95% CI:1.44-3.89,P＜0.001).The analysis results of different gender,age,and family income subgroups showed that the effect of cancer on the risk of depression was different among subgroups(P＜0.05). Conclusions Cancer is an independent risk factor for depression.Therefore,the assessment and intervention of mental health should be paid attention during the treatment of cancer patients.It is of great significance to screen for depression in cancer patients and intervene in them to improve the life quality of patients.In addition,paying attention to high-risk groups can help to implement targeted prevention and intervention and improve their mental health.

Key words: Cancer, Depression, Propensity score matching, Logistic regression