Bidirectional relationship between anxiety disorder and cancer: a longitudinal population-based cohort study

Abstract Background Although research has highlighted the link between anxiety and cancer, studies on the relationship between the two have produced inconsistent findings. Therefore, we investigated this relationship and also examined which types of cancer are more likely to induce anxiety. Methods...

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Main Authors: Sang-Hue Yen, Yi-Hsuan Hsu, Doreen Phiri, Chia-Chun Kuo, Hui-Fen Fang, Min-Huey Chung
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-13930-6
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author Sang-Hue Yen
Yi-Hsuan Hsu
Doreen Phiri
Chia-Chun Kuo
Hui-Fen Fang
Min-Huey Chung
author_facet Sang-Hue Yen
Yi-Hsuan Hsu
Doreen Phiri
Chia-Chun Kuo
Hui-Fen Fang
Min-Huey Chung
author_sort Sang-Hue Yen
collection DOAJ
description Abstract Background Although research has highlighted the link between anxiety and cancer, studies on the relationship between the two have produced inconsistent findings. Therefore, we investigated this relationship and also examined which types of cancer are more likely to induce anxiety. Methods This retrospective longitudinal cohort study, conducted in Taiwan from 2003 to 2016, looked at the risk of cancer in 23,255 patients with anxiety disorder and the risk of anxiety in 33,334 patients with cancer diagnosed between 2003 and 2005. For both analyses, a comparison cohort was created using 1:4 case-control sampling. Cox proportional hazard regression models were used to analyze factors related to anxiety disorder or cancer. Results Patients with anxiety were more likely to develop cancer (adjusted hazard ratio [AHR] = 1.29; 95% confidence interval [CI]: 1.23–1.35) compared to those in the comparison group. Particularly high risks were observed for thyroid cancer (AHR: 2.13, CI: 1.60–2.82), skin cancer (AHR: 2.10, CI: 1.63–2.71), and prostate cancer (AHR: 1.97, CI: 1.59–2.47). Patients with cancer were more likely to develop anxiety than those without cancer (AHR: 1.63, 95% CI: 1.56–1.71), with particularly high risks observed in those with nose cancer (AHR: 3.12, 95% CI: 2.41–4.03), leukemia (AHR: 2.54, 95% CI: 1.63–3.96), thyroid cancer (AHR: 2.34, 95% CI: 1.84–2.97), and oral cancer (AHR: 2.04, 95% CI: 1.65–2.52). Conclusions Our findings highlight a bidirectional link between cancer and anxiety disorder. Understanding this two-way connection can help healthcare providers develop effective strategies for managing cancer and anxiety disorders.
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spelling doaj-art-6cca79952d31418ca772efbbf291d07b2025-08-20T02:20:25ZengBMCBMC Cancer1471-24072025-04-0125111010.1186/s12885-025-13930-6Bidirectional relationship between anxiety disorder and cancer: a longitudinal population-based cohort studySang-Hue Yen0Yi-Hsuan Hsu1Doreen Phiri2Chia-Chun Kuo3Hui-Fen Fang4Min-Huey Chung5Division of Radiation Oncology, Department of Oncology, Taipei Veterans General HospitalSchool of Nursing, Taipei Medical UniversitySchool of Nursing, Taipei Medical UniversityPh.D. Program for Cancer Molecular Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University and Academia Sinica, Taipei Medical UniversityDirector of Administration Department, Taipei Cancer Center, Taipei Medical UniversitySchool of Nursing, Taipei Medical UniversityAbstract Background Although research has highlighted the link between anxiety and cancer, studies on the relationship between the two have produced inconsistent findings. Therefore, we investigated this relationship and also examined which types of cancer are more likely to induce anxiety. Methods This retrospective longitudinal cohort study, conducted in Taiwan from 2003 to 2016, looked at the risk of cancer in 23,255 patients with anxiety disorder and the risk of anxiety in 33,334 patients with cancer diagnosed between 2003 and 2005. For both analyses, a comparison cohort was created using 1:4 case-control sampling. Cox proportional hazard regression models were used to analyze factors related to anxiety disorder or cancer. Results Patients with anxiety were more likely to develop cancer (adjusted hazard ratio [AHR] = 1.29; 95% confidence interval [CI]: 1.23–1.35) compared to those in the comparison group. Particularly high risks were observed for thyroid cancer (AHR: 2.13, CI: 1.60–2.82), skin cancer (AHR: 2.10, CI: 1.63–2.71), and prostate cancer (AHR: 1.97, CI: 1.59–2.47). Patients with cancer were more likely to develop anxiety than those without cancer (AHR: 1.63, 95% CI: 1.56–1.71), with particularly high risks observed in those with nose cancer (AHR: 3.12, 95% CI: 2.41–4.03), leukemia (AHR: 2.54, 95% CI: 1.63–3.96), thyroid cancer (AHR: 2.34, 95% CI: 1.84–2.97), and oral cancer (AHR: 2.04, 95% CI: 1.65–2.52). Conclusions Our findings highlight a bidirectional link between cancer and anxiety disorder. Understanding this two-way connection can help healthcare providers develop effective strategies for managing cancer and anxiety disorders.https://doi.org/10.1186/s12885-025-13930-6Anxiety disorderCancerLongitudinal population-based studyBidirectional
spellingShingle Sang-Hue Yen
Yi-Hsuan Hsu
Doreen Phiri
Chia-Chun Kuo
Hui-Fen Fang
Min-Huey Chung
Bidirectional relationship between anxiety disorder and cancer: a longitudinal population-based cohort study
BMC Cancer
Anxiety disorder
Cancer
Longitudinal population-based study
Bidirectional
title Bidirectional relationship between anxiety disorder and cancer: a longitudinal population-based cohort study
title_full Bidirectional relationship between anxiety disorder and cancer: a longitudinal population-based cohort study
title_fullStr Bidirectional relationship between anxiety disorder and cancer: a longitudinal population-based cohort study
title_full_unstemmed Bidirectional relationship between anxiety disorder and cancer: a longitudinal population-based cohort study
title_short Bidirectional relationship between anxiety disorder and cancer: a longitudinal population-based cohort study
title_sort bidirectional relationship between anxiety disorder and cancer a longitudinal population based cohort study
topic Anxiety disorder
Cancer
Longitudinal population-based study
Bidirectional
url https://doi.org/10.1186/s12885-025-13930-6
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AT chiachunkuo bidirectionalrelationshipbetweenanxietydisorderandcanceralongitudinalpopulationbasedcohortstudy
AT huifenfang bidirectionalrelationshipbetweenanxietydisorderandcanceralongitudinalpopulationbasedcohortstudy
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