A nationwide population-based cohort study: will anxiety disorders increase subsequent cancer risk?

PLoS One. 2012;7(4):e36370. doi: 10.1371/journal.pone.0036370. Epub 2012 Apr 27.

Abstract

Background: The aim of this study was to evaluate a possible association between malignancy and anxiety disorders (AD) in Taiwan.

Methods: We employed data from the National Health Insurance system of Taiwan. The AD cohort contained 24,066 patients with each patient randomly frequency matched according to age and sex with 4 individuals from the general population without AD. Cox's proportional hazard regression analysis was conducted to estimate the influence of AD on the risk of cancer.

Results: Among patients with AD, the overall risk of developing cancer was only 1% higher than among subjects without AD, and the difference was not significant (hazard ratio [HR] = 1.01, 95% confidence interval [95% CI] = 0.95-1.07). With regard to individual types of cancer, the risk of developing prostate cancer among male patients with AD was significantly higher (HR = 1.32, 95% CI = 1.02-1.71). On the other hand, the risk of cervical cancer among female patients with AD was marginally significantly lower than among female subjects without AD (HR = 0.72, 95% CI = 0.51-1.03).

Limitations: One major limitation is the lack of information regarding the life style or behavior of patients in the NHI database, such as smoking and alcohol consumption.

Conclusions: Despite the failure to identify a relationship between AD and the overall risk of cancer, we found that Taiwanese patients with AD had a higher risk of developing prostate cancer and a lower risk of developing cervical cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anxiety Disorders / complications*
  • Anxiety Disorders / epidemiology*
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Neoplasms / diagnosis
  • Neoplasms / epidemiology*
  • Proportional Hazards Models
  • Prostatic Neoplasms / complications
  • Prostatic Neoplasms / diagnosis
  • Prostatic Neoplasms / epidemiology
  • Retrospective Studies
  • Risk
  • Taiwan / epidemiology
  • Uterine Cervical Neoplasms / complications
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / epidemiology