Adjustment disorder and type-specific cancer incidence: a Danish cohort study

Authors

  • Thomas P. Ahern Department of Surgery, Larner College of Medicine, University of Vermont, Burlington, VT, USA; ;Department of Biochemistry, Larner College of Medicine, University of Vermont, Burlington, VT, USA
  • Katalin Veres Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
  • Tammy Jiang Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
  • Dóra Körmendiné Farkas Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
  • Timothy L. Lash Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark; ;Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
  • Henrik Toft Sørensen Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
  • Jaimie L. Gradus Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark; ;Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA; ;Department of Psychiatry, Boston University School of Public Health, Boston, MA, USA; ;National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA

DOI:

https://doi.org/10.1080/0284186X.2018.1465586

Abstract

Background: Although adjustment disorder is common, there is a dearth of research on its physical health consequences. Earlier studies, biological mechanisms and stress-related behaviors suggest that cancer may be a potential sequelae of adjustment disorder. This study examined the association between adjustment disorder and type-specific cancer incidence in a nationwide cohort.

Methods: Data were obtained from the comprehensive nationwide medical and administrative registries of Denmark. We calculated the incidence of type-specific cancers from 1995 to 2013 in patients with a prior adjustment disorder diagnosis (n = 58,712), and compared it with the incidence in the general population by calculating standardized incidence ratios (SIRs) with accompanying 95% confidence intervals (CIs). SIRs were adjusted using semi-Bayes shrinkage.

Results: The SIR for any type of cancer was 1.0 (95% CI: 0.99, 1.1). Adjustment disorder was associated with a 10% lower rate of immune-related cancers (SIR = 0.9, 95% CI: 0.84, 0.97) and with a 20% higher rate of smoking- and alcohol-related cancers (SIR = 1.2, 95% CI: 1.1, 1.3). We found null associations for hematological (SIR = 1.1, 95% CI: 0.89, 1.3) and hormone-related (SIR = 0.98, 95% CI: 0.91, 1.1) malignancies. After semi-Bayes adjustment, type-specific cancer SIRs indicated no association between adjustment disorder and cancer incidence.

Conclusions: This study provides persuasive evidence for a null association between adjustment disorder and type-specific cancer incidence in a nationwide study cohort.

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Published

2018-10-03

How to Cite

Ahern, T. P. ., Veres, K. ., Jiang, T. ., Körmendiné Farkas, D., Lash, T. L. ., Toft Sørensen, H. ., & Gradus, J. L. . (2018). Adjustment disorder and type-specific cancer incidence: a Danish cohort study. Acta Oncologica, 57(10), 1367–1372. https://doi.org/10.1080/0284186X.2018.1465586

Issue

Vol. 57 No. 10 (2018): Acta Oncologica

Section

Articles