Epidemiology, IQVIA, Frankfurt, Germany.
Department of Physical Medicine and Rehabilitation, Université Paris Cité, AP-HP, Lariboisière-Fernand Widal Hospital, Paris, France.
J Cancer Res Clin Oncol. 2023 Nov;149(16):14509-14518. doi: 10.1007/s00432-023-05229-5. Epub 2023 Aug 12.
Psychiatric disorders and cancer are both common, and comorbidity has detrimental impacts on cancer outcomes. Previous studies focus on affective disorders which arise after cancer diagnosis, not on the impact of psychiatric disorders on cancer risk. We investigate the association between psychiatric disorders and subsequent gastrointestinal cancer in a large cohort in Germany.
This case-control study used secondary data (electronic medical records) from the national IQVIA Disease Analyzer database. We evaluated the association between previous psychiatric diagnosis in 44,582 matched patients with and without gastrointestinal (GI) cancer. Regression analyses were stratified by psychiatric diagnosis and adjusted by chronic comorbidities and previous psychiatric treatments.
No association between any previous psychiatric disease and GI cancers was found (OR = 0.98 (0.95-1.02 95%CL, p = 0.39). Previous psychosomatic disorder and GI cancer showed a significant negative association (OR: 0.86, 0.81-0.90 95%CL, p < 0.0001). No association was found between previous diagnosis with depression or PTSD and GI cancer. These results remained consistent when including previous psychiatric treatments in the regression analyses.
Psychiatric disease was not associated with GI cancer risk. Further investigation into the pathways linking psychiatric disease and cancer needs to be conducted, taking into consideration psychiatric treatments administered, to enhance our understanding of the relationship between these two common and devastating diseases.
精神疾病和癌症都很常见,且共病对癌症结局有不利影响。既往研究主要关注癌症诊断后出现的情感障碍,而不是精神疾病对癌症风险的影响。我们在德国的一个大型队列中研究了精神疾病与随后发生的胃肠道癌症之间的关联。
本病例对照研究使用了国家 IQVIA 疾病分析器数据库中的二级数据(电子病历)。我们评估了 44582 例匹配的胃肠道(GI)癌症患者和无胃肠道癌症患者之间先前精神诊断的关联。回归分析按精神诊断分层,并通过慢性合并症和先前的精神治疗进行调整。
未发现任何先前的精神疾病与 GI 癌症之间存在关联(OR=0.98(0.95-1.02 95%CL,p=0.39))。先前的身心障碍与 GI 癌症呈显著负相关(OR:0.86,0.81-0.90 95%CL,p<0.0001)。先前诊断为抑郁症或创伤后应激障碍与 GI 癌症之间无关联。当将先前的精神治疗纳入回归分析时,这些结果仍然一致。
精神疾病与 GI 癌症风险无关。需要进一步研究将精神疾病与癌症联系起来的途径,同时考虑到给予的精神治疗,以增强我们对这两种常见且具有破坏性疾病之间关系的理解。