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January 26, 1990

Cancer and Psychosocial Traits, Continued

JAMA. 1990;263(4):513. doi:10.1001/jama.1990.03440040052013

To the Editor.—  In the September 1, 1989, issue of JAMA, Zonderman et al1 report that depression, as measured by the General Well-being Schedule and the Center for Epidemiologic Studies Depression scale, is not predictive of cancer morbidity or mortality in a 10-year follow-up. However, a breakdown of cancer morbidity by site was not reported.Given that immunity is the most popular hypothetical mediating factor between depression and cancer,2,3 the type of cancers that have been shown to be most sensitive to immune factors ought to be examined. Previous results have shown an increased incidence only of certain neoplasms in patients in chronic immunodeficiency states.4-7 The incidence of lymphomas, carcinomas of the lip and skin, carcinomas of the vulva, in situ carcinomas of the uterine cervix, and leukemias is greater in organ transplant recipients and other chronically immunosupressed patients than in the general population.7 The most frequently