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

Lonneke A. van Tuijl; Maartje Basten; Kuan-Yu Pan; Roel Vermeulen; Luetzen 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: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, Luetzen 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

^*Corresponding author for this work

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

Abstract

BackgroundDepression 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. MethodsThe 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). ResultsNo 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). ConclusionsDepression 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.

Original language	English
Pages (from-to)	3287-3299
Number of pages	13
Journal	Cancer
Volume	129
Issue number	20
Early online date	1 Aug 2023
DOIs	https://doi.org/10.1002/cncr.34853
Publication status	Published - 15 Oct 2023

Keywords

anxiety
cancer
depression
meta-analysis
risk
COHORT PROFILE
HEALTH
PARTNERSHIP
OBJECTIVES
RATIONALE
PROJECT
MOOD

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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{dbbed278e6ec43bf96554beeda83441d,

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

abstract = "BackgroundDepression 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. MethodsThe 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). ResultsNo 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). ConclusionsDepression 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.",

keywords = "anxiety, cancer, depression, meta-analysis, risk, COHORT PROFILE, HEALTH, PARTNERSHIP, OBJECTIVES, RATIONALE, PROJECT, MOOD",

author = "{van Tuijl}, {Lonneke A.} and Maartje Basten and Kuan-Yu Pan and Roel Vermeulen and Luetzen 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.}",

year = "2023",

month = oct,

day = "15",

doi = "10.1002/cncr.34853",

language = "English",

volume = "129",

pages = "3287--3299",

journal = "Cancer",

issn = "0008-543X",

publisher = "John Wiley & Sons Inc.",

number = "20",

}

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, Luetzen

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 - BackgroundDepression 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. MethodsThe 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). ResultsNo 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). ConclusionsDepression 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.

AB - BackgroundDepression 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. MethodsThe 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). ResultsNo 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). ConclusionsDepression 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.

KW - anxiety

KW - cancer

KW - depression

KW - meta-analysis

KW - risk

KW - COHORT PROFILE

KW - HEALTH

KW - PARTNERSHIP

KW - OBJECTIVES

KW - RATIONALE

KW - PROJECT

KW - MOOD

U2 - 10.1002/cncr.34853

DO - 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

Abstract

Keywords

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