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

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  • Thomas P Ahern
  • Katalin Veres
  • Tammy Jiang, d Department of Epidemiology , Boston University School of Public Health , Boston , MA , USA.
  • ,
  • Dóra Körmendiné Farkas
  • Timothy L Lash
  • Henrik Toft Sørensen
  • Jaimie L Gradus, *Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus C, Denmark †The Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark ‡Department of Surgery, Aarhus University Hospital, Aarhus C, Denmark., d Department of Epidemiology , Boston University School of Public Health , Boston , MA , USA., f Department of Psychiatry , Boston University School of Public Health , Boston , MA , USA., g National Center for PTSD, VA Boston Healthcare System , Boston , MA , USA.

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.

Original languageEnglish
JournalActa oncologica (Stockholm, Sweden)
Volume57
Issue10
Pages (from-to)1367-1372
Number of pages6
ISSN0284-186X
DOIs
Publication statusPublished - Oct 2018

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