Abstract
The literature provides evidence of the negative impact of depression on mortality among cancer patients. Depression is also a common comorbidity in pancreatic cancer (PC). The objective of this systematic review was to provide a state-of-the-art overview of the potential role of depression in the excess mortality observed in patients with PC. Based on PRISMA guidelines, a systematic review (PROSPERO: CRD420251135451) was conducted in August 2025 using the Pubmed-Medline and Scopus database. After assessment by two readers of the 325 identified articles, 8 articles (n = 143,033) published between 1 January 2010 and 15 August 2025 investigating the specific impact of depression (diagnosed by psychiatric interviews, self-report questionnaires, or diagnostic codes) on mortality in patients with PC (diagnosed by clinical diagnosis or diagnostic codes) were included in this systematic literature review. Articles that were not research studies and were written in a language other than English/French were not included. Risk of bias was assessed using the ROBINS-I tool. A narrative synthesis of the results was performed for the potential impact of depression on mortality in patients with PC. The reported prevalence of depression in this population ranged from 7.4% to 51.8% (seven studies, n = 142,983), depending on the studies considered. Most of the included studies (seven studies, n = 141,728) consistently reported an increased risk of mortality associated with depression, regardless of cancer stage or treatment received. However, the scientific quality of these studies was generally low, with a significant risk of bias. These results suggest that better integration of depression management in the care of patients with PC could potentially improve clinical outcomes in this high-risk population.