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. 2023 Nov;149(16):14509-14518.
doi: 10.1007/s00432-023-05229-5. Epub 2023 Aug 12.

Psychiatric disorder and its association with gastrointestinal cancer: a retrospective cohort study with 45,842 patients in Germany

Hannah Moessinger  1 , Louis Jacob  2   3   4 , Lee Smith  5 , Ai Koyanagi  4   6 , Karel Kostev  7   8
Affiliations

Psychiatric disorder and its association with gastrointestinal cancer: a retrospective cohort study with 45,842 patients in Germany

Hannah Moessinger et al. J Cancer Res Clin Oncol. 2023 Nov.

Abstract

Purpose: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Cancer; General physicians; Germany; Outpatients; Psychiatric disease.

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Conflict of interest statement

The authors declare no competing interests.

The authors declare that they have no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Fig. 1
Fig. 1
Flow chart showing study cohort selection. (Kessler et al. 2007) Patients from the control group were matched to the patients with cancer of the gastrointestinal system and digestive organs (cases) using 1:1 matching of nearest neighbors (no replacement) with a maximum caliper of 0.2
Fig. 2
Fig. 2
Association between previous psychiatric disease and GI cancer risk. Risk for cancers of the gastrointestinal tract was determined by odds ratio (OR) and confidence limits (CL), comparing patients with a cancer diagnosis to matched patients without a cancer diagnosis (reference). A ORs were adjusted for by previous chronic comorbidities. B ORs were adjusted for by previous chronic comorbidities and previous psychiatric treatment. PTSD: post–traumatic stress disorder; ADHD: attention–deficit (hyperactivity) disorder; *p < 0.05, **p < 0.001. Total counts were N = 45,842, with 50% of cases with gastrointestinal cancer
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