Abstract
Data on the leading shared risk factors of cancer and mental disorders are limited. We included 98,958 participants (54.8% women) aged 45–64 years from the 45 and Up Study who were free of cancer, depression, and anxiety at baseline (2006–2009). The incidence of cancer, mental disorders, and multimorbidity (concurrent cancer and mental disorders) was identified using claim databases during follow-up until 31 December 2016. During a nine-year follow-up, the cumulative incidence of cancer, mental disorders, and multimorbidity was 8.8%, 17.4%, and 2.2%, respectively. Participants with cancer were 3.41 times more likely to develop mental disorders, while individuals with mental disorders were 3.06 times more likely to develop cancer than people without these conditions. The shared risk factors for cancer and mental disorders were older age, female gender, smoking, psychological distress, low fruit intake, poor/fair self-rated health, hypertension, arthritis, asthma, and diabetes. Low education, low income, overweight/obesity, and family history of depression were risk factors for mental disorders and multimorbidity but not cancer. In conclusion, smoking, low fruit intake, and obesity are key modifiable factors for the prevention of cancer and mental disorders. Individuals with poor/fair self-rated health, high psychological distress, asthma, hypertension, arthritis, or diabetes should be targeted for the prevention and screening of cancer and mental disorders.
Highlights
Global cancer cases increased from 13.4 million in 2006 to 17.2 million in 2016 [1], and this number is expected to grow rapidly in the decade due to population growth and aging [1]
Cox proportional regression models were used to examine whether the incidence of cancer and mental disorders multimorbidity differed by gender and by age groups after adjustment for the country of birth, income, education, health insurance, lifestyle factors, medical history, family history of conditions, Body mass index (BMI), self-rated overall health, and quality of life. (B) The incidence of mental disorders within seven years in individuals with cancer and in the general population by age and gender groups. (C) The incidence of cancer within seven years in individuals with mental disorders and in the general population by age and gender groups
We further found that the positive association between existing cancer and incidence of mental disorders was more evident in men than women, which was not reported in previous studies
Summary
Global cancer cases increased from 13.4 million in 2006 to 17.2 million in 2016 [1], and this number is expected to grow rapidly in the decade due to population growth and aging [1]. In 2015, cancer, which accounted for over 8.7 million deaths, was the second leading cause of global mortality [2]. The concurrence of mental disorders and cancer (multimorbidity) imposes a tremendous burden on the healthcare system. The common coexistence of cancer and mental disorders suggests there may be shared risk factors for these. The leading predictors for the multimorbidity were not examined, and whether these predictors are shared by cancer and mental disorders is not known. Determining shared risk factors for mental disorders and cancer would help prevent and manage multimorbidity and minimize deaths caused by these concurrent conditions. We analyzed whether the selected leading predictors for multimorbidity were independently associated with incident multimorbidity, as well as cancer and mental disorders
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