Depression, anxiety, and the risk of cancer: An individual participant data meta-analysis

Lonneke A van Tuijl; Maartje Basten; Kuan-Yu Pan; Roel Vermeulen; Lützen Portengen; Alexander de Graeff; Joost Dekker; Mirjam I Geerlings; Adriaan Hoogendoorn; Femke Lamers; Adri C Voogd; Jessica Abell; Philip Awadalla; Aartjan T F Beekman; Ottar Bjerkeset; Andy Boyd; Yunsong Cui; Philipp Frank; Henrike Galenkamp; Bert Garssen; Sean Hellingman; Martijn Huisman; Anke Huss; Trynke R de Jong; Melanie R Keats; Almar A L Kok; Steinar Krokstad; Flora E van Leeuwen; Annemarie I Luik; Nolwenn Noisel; N Charlotte Onland-Moret; Yves Payette; Brenda W J H Penninx; Ina Rissanen; Annelieke M Roest; Rikje Ruiter; Robert A Schoevers; David Soave; Mandy Spaan; Andrew Steptoe; Karien Stronks; Erik R Sund; Ellen Sweeney; Emma L Twait; Alison Teyhan; W M Monique Verschuren; Kimberly D van der Willik; Judith G M Rosmalen; Adelita V Ranchor

doi:https://doi.org/10.1002/cncr.34853

Depression, anxiety, and the risk of cancer: An individual participant data meta-analysis

Lonneke A van Tuijl, Maartje Basten, Kuan-Yu Pan, Roel Vermeulen, Lützen Portengen, Alexander de Graeff, Joost Dekker, Mirjam I Geerlings, Adriaan Hoogendoorn, Femke Lamers, Adri C Voogd, Jessica Abell, Philip Awadalla, Aartjan T F Beekman, Ottar Bjerkeset, Andy Boyd, Yunsong Cui, Philipp Frank, Henrike Galenkamp, Bert GarssenSean Hellingman, Martijn Huisman, Anke Huss, Trynke R de Jong, Melanie R Keats, Almar A L Kok, Steinar Krokstad, Flora E van Leeuwen, Annemarie I Luik, Nolwenn Noisel, N Charlotte Onland-Moret, Yves Payette, Brenda W J H Penninx, Ina Rissanen, Annelieke M Roest, Rikje Ruiter, Robert A Schoevers, David Soave, Mandy Spaan, Andrew Steptoe, Karien Stronks, Erik R Sund, Ellen Sweeney, Emma L Twait, Alison Teyhan, W M Monique Verschuren, Kimberly D van der Willik, Judith G M Rosmalen, Adelita V Ranchor

Research output: Contribution to journal › Article › Academic › peer-review

3 Citations (Scopus)

Abstract

BACKGROUND: Depression and anxiety have long been hypothesized to be related to an increased cancer risk. Despite the great amount of research that has been conducted, findings are inconclusive. To provide a stronger basis for addressing the associations between depression, anxiety, and the incidence of various cancer types (overall, breast, lung, prostate, colorectal, alcohol-related, and smoking-related cancers), individual participant data (IPD) meta-analyses were performed within the Psychosocial Factors and Cancer Incidence (PSY-CA) consortium.

METHODS: The PSY-CA consortium includes data from 18 cohorts with measures of depression or anxiety (up to N = 319,613; cancer incidences, 25,803; person-years of follow-up, 3,254,714). Both symptoms and a diagnosis of depression and anxiety were examined as predictors of future cancer risk. Two-stage IPD meta-analyses were run, first by using Cox regression models in each cohort (stage 1), and then by aggregating the results in random-effects meta-analyses (stage 2).

RESULTS: No associations were found between depression or anxiety and overall, breast, prostate, colorectal, and alcohol-related cancers. Depression and anxiety (symptoms and diagnoses) were associated with the incidence of lung cancer and smoking-related cancers (hazard ratios [HRs], 1.06-1.60). However, these associations were substantially attenuated when additionally adjusting for known risk factors including smoking, alcohol use, and body mass index (HRs, 1.04-1.23).

CONCLUSIONS: Depression and anxiety are not related to increased risk for most cancer outcomes, except for lung and smoking-related cancers. This study shows that key covariates are likely to explain the relationship between depression, anxiety, and lung and smoking-related cancers. PREREGISTRATION NUMBER: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=157677.

Original language	English
Pages (from-to)	3287-3299
Number of pages	13
Journal	Cancer
Volume	129
Issue number	20
Early online date	2023
DOIs	https://doi.org/10.1002/cncr.34853
Publication status	Published - 15 Oct 2023

Keywords

Anxiety/complications
Colorectal Neoplasms/epidemiology
Depression/complications
Humans
Lung Neoplasms/epidemiology
Male
Risk Factors
anxiety
cancer
depression
meta-analysis
risk

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van Tuijl, L. A., Basten, M., Pan, K.-Y., Vermeulen, R., Portengen, L., de Graeff, A., Dekker, J., Geerlings, M. I., Hoogendoorn, A., Lamers, F., Voogd, A. C., Abell, J., Awadalla, P., Beekman, A. T. F., Bjerkeset, O., Boyd, A., Cui, Y., Frank, P., Galenkamp, H., ... Ranchor, A. V. (2023). Depression, anxiety, and the risk of cancer: An individual participant data meta-analysis. Cancer, 129(20), 3287-3299. https://doi.org/10.1002/cncr.34853

@article{a1d1040db8404810b0cb4d3df7dc387a,

title = "Depression, anxiety, and the risk of cancer: An individual participant data meta-analysis",

abstract = "BACKGROUND: Depression and anxiety have long been hypothesized to be related to an increased cancer risk. Despite the great amount of research that has been conducted, findings are inconclusive. To provide a stronger basis for addressing the associations between depression, anxiety, and the incidence of various cancer types (overall, breast, lung, prostate, colorectal, alcohol-related, and smoking-related cancers), individual participant data (IPD) meta-analyses were performed within the Psychosocial Factors and Cancer Incidence (PSY-CA) consortium.METHODS: The PSY-CA consortium includes data from 18 cohorts with measures of depression or anxiety (up to N = 319,613; cancer incidences, 25,803; person-years of follow-up, 3,254,714). Both symptoms and a diagnosis of depression and anxiety were examined as predictors of future cancer risk. Two-stage IPD meta-analyses were run, first by using Cox regression models in each cohort (stage 1), and then by aggregating the results in random-effects meta-analyses (stage 2).RESULTS: No associations were found between depression or anxiety and overall, breast, prostate, colorectal, and alcohol-related cancers. Depression and anxiety (symptoms and diagnoses) were associated with the incidence of lung cancer and smoking-related cancers (hazard ratios [HRs], 1.06-1.60). However, these associations were substantially attenuated when additionally adjusting for known risk factors including smoking, alcohol use, and body mass index (HRs, 1.04-1.23).CONCLUSIONS: Depression and anxiety are not related to increased risk for most cancer outcomes, except for lung and smoking-related cancers. This study shows that key covariates are likely to explain the relationship between depression, anxiety, and lung and smoking-related cancers. PREREGISTRATION NUMBER: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=157677.",

keywords = "Anxiety/complications, Colorectal Neoplasms/epidemiology, Depression/complications, Humans, Lung Neoplasms/epidemiology, Male, Risk Factors, anxiety, cancer, depression, meta-analysis, risk",

author = "{van Tuijl}, {Lonneke A} and Maartje Basten and Kuan-Yu Pan and Roel Vermeulen and L{\"u}tzen Portengen and {de Graeff}, Alexander and Joost Dekker and Geerlings, {Mirjam I} and Adriaan Hoogendoorn and Femke Lamers and Voogd, {Adri C} and Jessica Abell and Philip Awadalla and Beekman, {Aartjan T F} and Ottar Bjerkeset and Andy Boyd and Yunsong Cui and Philipp Frank and Henrike Galenkamp and Bert Garssen and Sean Hellingman and Martijn Huisman and Anke Huss and {de Jong}, {Trynke R} and Keats, {Melanie R} and Kok, {Almar A L} and Steinar Krokstad and {van Leeuwen}, {Flora E} and Luik, {Annemarie I} and Nolwenn Noisel and Onland-Moret, {N Charlotte} and Yves Payette and Penninx, {Brenda W J H} and Ina Rissanen and Roest, {Annelieke M} and Rikje Ruiter and Schoevers, {Robert A} and David Soave and Mandy Spaan and Andrew Steptoe and Karien Stronks and Sund, {Erik R} and Ellen Sweeney and Twait, {Emma L} and Alison Teyhan and Verschuren, {W M Monique} and {van der Willik}, {Kimberly D} and Rosmalen, {Judith G M} and Ranchor, {Adelita V}",

note = "{\textcopyright} 2023 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.",

year = "2023",

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day = "15",

doi = "https://doi.org/10.1002/cncr.34853",

language = "English",

volume = "129",

pages = "3287--3299",

journal = "Cancer",

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publisher = "John Wiley and Sons Inc.",

number = "20",

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van Tuijl, LA, Basten, M, Pan, K-Y, Vermeulen, R, Portengen, L, de Graeff, A, Dekker, J , Geerlings, MI , Hoogendoorn, A , Lamers, F, Voogd, AC, Abell, J, Awadalla, P, Beekman, ATF, Bjerkeset, O, Boyd, A, Cui, Y, Frank, P, Galenkamp, H, Garssen, B, Hellingman, S, Huisman, M, Huss, A, de Jong, TR, Keats, MR, Kok, AAL, Krokstad, S, van Leeuwen, FE, Luik, AI, Noisel, N, Onland-Moret, NC, Payette, Y, Penninx, BWJH, Rissanen, I, Roest, AM, Ruiter, R, Schoevers, RA, Soave, D, Spaan, M, Steptoe, A, Stronks, K, Sund, ER, Sweeney, E, Twait, EL, Teyhan, A, Verschuren, WMM, van der Willik, KD, Rosmalen, JGM & Ranchor, AV 2023, 'Depression, anxiety, and the risk of cancer: An individual participant data meta-analysis', Cancer, vol. 129, no. 20, pp. 3287-3299. https://doi.org/10.1002/cncr.34853

TY - JOUR

T1 - Depression, anxiety, and the risk of cancer

T2 - An individual participant data meta-analysis

AU - van Tuijl, Lonneke A

AU - Basten, Maartje

AU - Pan, Kuan-Yu

AU - Vermeulen, Roel

AU - Portengen, Lützen

AU - de Graeff, Alexander

AU - Dekker, Joost

AU - Geerlings, Mirjam I

AU - Hoogendoorn, Adriaan

AU - Lamers, Femke

AU - Voogd, Adri C

AU - Abell, Jessica

AU - Awadalla, Philip

AU - Beekman, Aartjan T F

AU - Bjerkeset, Ottar

AU - Boyd, Andy

AU - Cui, Yunsong

AU - Frank, Philipp

AU - Galenkamp, Henrike

AU - Garssen, Bert

AU - Hellingman, Sean

AU - Huisman, Martijn

AU - Huss, Anke

AU - de Jong, Trynke R

AU - Keats, Melanie R

AU - Kok, Almar A L

AU - Krokstad, Steinar

AU - van Leeuwen, Flora E

AU - Luik, Annemarie I

AU - Noisel, Nolwenn

AU - Onland-Moret, N Charlotte

AU - Payette, Yves

AU - Penninx, Brenda W J H

AU - Rissanen, Ina

AU - Roest, Annelieke M

AU - Ruiter, Rikje

AU - Schoevers, Robert A

AU - Soave, David

AU - Spaan, Mandy

AU - Steptoe, Andrew

AU - Stronks, Karien

AU - Sund, Erik R

AU - Sweeney, Ellen

AU - Twait, Emma L

AU - Teyhan, Alison

AU - Verschuren, W M Monique

AU - van der Willik, Kimberly D

AU - Rosmalen, Judith G M

AU - Ranchor, Adelita V

PY - 2023/10/15

Y1 - 2023/10/15

N2 - BACKGROUND: Depression and anxiety have long been hypothesized to be related to an increased cancer risk. Despite the great amount of research that has been conducted, findings are inconclusive. To provide a stronger basis for addressing the associations between depression, anxiety, and the incidence of various cancer types (overall, breast, lung, prostate, colorectal, alcohol-related, and smoking-related cancers), individual participant data (IPD) meta-analyses were performed within the Psychosocial Factors and Cancer Incidence (PSY-CA) consortium.METHODS: The PSY-CA consortium includes data from 18 cohorts with measures of depression or anxiety (up to N = 319,613; cancer incidences, 25,803; person-years of follow-up, 3,254,714). Both symptoms and a diagnosis of depression and anxiety were examined as predictors of future cancer risk. Two-stage IPD meta-analyses were run, first by using Cox regression models in each cohort (stage 1), and then by aggregating the results in random-effects meta-analyses (stage 2).RESULTS: No associations were found between depression or anxiety and overall, breast, prostate, colorectal, and alcohol-related cancers. Depression and anxiety (symptoms and diagnoses) were associated with the incidence of lung cancer and smoking-related cancers (hazard ratios [HRs], 1.06-1.60). However, these associations were substantially attenuated when additionally adjusting for known risk factors including smoking, alcohol use, and body mass index (HRs, 1.04-1.23).CONCLUSIONS: Depression and anxiety are not related to increased risk for most cancer outcomes, except for lung and smoking-related cancers. This study shows that key covariates are likely to explain the relationship between depression, anxiety, and lung and smoking-related cancers. PREREGISTRATION NUMBER: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=157677.

AB - BACKGROUND: Depression and anxiety have long been hypothesized to be related to an increased cancer risk. Despite the great amount of research that has been conducted, findings are inconclusive. To provide a stronger basis for addressing the associations between depression, anxiety, and the incidence of various cancer types (overall, breast, lung, prostate, colorectal, alcohol-related, and smoking-related cancers), individual participant data (IPD) meta-analyses were performed within the Psychosocial Factors and Cancer Incidence (PSY-CA) consortium.METHODS: The PSY-CA consortium includes data from 18 cohorts with measures of depression or anxiety (up to N = 319,613; cancer incidences, 25,803; person-years of follow-up, 3,254,714). Both symptoms and a diagnosis of depression and anxiety were examined as predictors of future cancer risk. Two-stage IPD meta-analyses were run, first by using Cox regression models in each cohort (stage 1), and then by aggregating the results in random-effects meta-analyses (stage 2).RESULTS: No associations were found between depression or anxiety and overall, breast, prostate, colorectal, and alcohol-related cancers. Depression and anxiety (symptoms and diagnoses) were associated with the incidence of lung cancer and smoking-related cancers (hazard ratios [HRs], 1.06-1.60). However, these associations were substantially attenuated when additionally adjusting for known risk factors including smoking, alcohol use, and body mass index (HRs, 1.04-1.23).CONCLUSIONS: Depression and anxiety are not related to increased risk for most cancer outcomes, except for lung and smoking-related cancers. This study shows that key covariates are likely to explain the relationship between depression, anxiety, and lung and smoking-related cancers. PREREGISTRATION NUMBER: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=157677.

KW - Anxiety/complications

KW - Colorectal Neoplasms/epidemiology

KW - Depression/complications

KW - Humans

KW - Lung Neoplasms/epidemiology

KW - Male

KW - Risk Factors

KW - anxiety

KW - cancer

KW - depression

KW - meta-analysis

KW - risk

UR - http://www.scopus.com/inward/record.url?scp=85166974379&partnerID=8YFLogxK

U2 - https://doi.org/10.1002/cncr.34853

DO - https://doi.org/10.1002/cncr.34853

M3 - Article

C2 - 37545248

SN - 0008-543X

VL - 129

SP - 3287

EP - 3299

JO - Cancer

JF - Cancer

IS - 20

ER -

Depression, anxiety, and the risk of cancer: An individual participant data meta-analysis

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Keywords

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