Eating Disorders and Later Incidence of Cancer: A Nationwide Longitudinal Study in Denmark
Background: We examined the incidence of cancer types among individuals with eating disorders (EDs). Methods: A nationwide longitudinal study of 6,807,731 individuals born between 1940 and 2015 was conducted using the Danish National Registries. Cox models with ED diagnosis as exposure and cancer di...
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Elsevier
2025-07-01
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| Series: | Biological Psychiatry Global Open Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667174325000370 |
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| author | Gabrielle E. Cooper Natalie M. Papini Katrine Holde Cynthia M. Bulik Zeynep Yilmaz Liselotte V. Petersen |
| author_facet | Gabrielle E. Cooper Natalie M. Papini Katrine Holde Cynthia M. Bulik Zeynep Yilmaz Liselotte V. Petersen |
| author_sort | Gabrielle E. Cooper |
| collection | DOAJ |
| description | Background: We examined the incidence of cancer types among individuals with eating disorders (EDs). Methods: A nationwide longitudinal study of 6,807,731 individuals born between 1940 and 2015 was conducted using the Danish National Registries. Cox models with ED diagnosis as exposure and cancer diagnoses as outcomes were used to estimate hazard ratios (HRs) and 95% CIs while adjusting for sex, birth year, and comorbidities. The primary analysis comprised ICD-8 and ICD-10 codes for anorexia nervosa (AN) and other ED (OED). The secondary analysis comprised ICD-10 codes and included AN, bulimia nervosa (BN), and eating disorders not otherwise specified (EDNOS). Results: AN was associated with a reduced incidence of breast cancer while adjusting for sex and birth year (HR, 0.80; 95% CI, 0.66–0.97) and elevated incidence of respiratory (HR, 1.59; 95% CI, 1.24–2.04), cervical (HR, 1.45; 95% CI, 1.05–1.98), and esophageal (HR, 4.77; 95% CI, 2.82–8.06) cancers. OED was associated with an elevated incidence of respiratory (HR, 1.57; 95% CI, 1.20–2.06) and cervical (HR, 1.60; 95% CI, 1.20–2.14) cancers. ICD-10–only analyses confirmed the association of AN with reduced incidence of breast cancer and elevated incidence of respiratory and cervical cancers. BN was associated with reduced incidence of breast cancer in sensitivity analysis. EDNOS was associated with reduced incidence of breast cancer and elevated incidence of respiratory and cervical cancers. Conclusions: All EDs were associated with a reduced incidence of breast cancer. All EDs except BN were associated with a higher incidence of respiratory and cervical cancers. AN was associated with a higher incidence of esophageal cancer. |
| format | Article |
| id | doaj-art-fabe0febfcf44e4ab6e459d04cda94a4 |
| institution | DOAJ |
| issn | 2667-1743 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Biological Psychiatry Global Open Science |
| spelling | doaj-art-fabe0febfcf44e4ab6e459d04cda94a42025-08-20T03:10:25ZengElsevierBiological Psychiatry Global Open Science2667-17432025-07-015410048310.1016/j.bpsgos.2025.100483Eating Disorders and Later Incidence of Cancer: A Nationwide Longitudinal Study in DenmarkGabrielle E. Cooper0Natalie M. Papini1Katrine Holde2Cynthia M. Bulik3Zeynep Yilmaz4Liselotte V. Petersen5Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North CarolinaDepartment of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Health Sciences, Northern Arizona University, Flagstaff, ArizonaNational Centre for Register-Based Research, Aarhus University, Aarhus, DenmarkDepartment of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North CarolinaDepartment of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Biomedicine, Aarhus University, Aarhus, DenmarkNational Centre for Register-Based Research, Aarhus University, Aarhus, Denmark; Address correspondence to Liselotte V. Petersen, Ph.D.Background: We examined the incidence of cancer types among individuals with eating disorders (EDs). Methods: A nationwide longitudinal study of 6,807,731 individuals born between 1940 and 2015 was conducted using the Danish National Registries. Cox models with ED diagnosis as exposure and cancer diagnoses as outcomes were used to estimate hazard ratios (HRs) and 95% CIs while adjusting for sex, birth year, and comorbidities. The primary analysis comprised ICD-8 and ICD-10 codes for anorexia nervosa (AN) and other ED (OED). The secondary analysis comprised ICD-10 codes and included AN, bulimia nervosa (BN), and eating disorders not otherwise specified (EDNOS). Results: AN was associated with a reduced incidence of breast cancer while adjusting for sex and birth year (HR, 0.80; 95% CI, 0.66–0.97) and elevated incidence of respiratory (HR, 1.59; 95% CI, 1.24–2.04), cervical (HR, 1.45; 95% CI, 1.05–1.98), and esophageal (HR, 4.77; 95% CI, 2.82–8.06) cancers. OED was associated with an elevated incidence of respiratory (HR, 1.57; 95% CI, 1.20–2.06) and cervical (HR, 1.60; 95% CI, 1.20–2.14) cancers. ICD-10–only analyses confirmed the association of AN with reduced incidence of breast cancer and elevated incidence of respiratory and cervical cancers. BN was associated with reduced incidence of breast cancer in sensitivity analysis. EDNOS was associated with reduced incidence of breast cancer and elevated incidence of respiratory and cervical cancers. Conclusions: All EDs were associated with a reduced incidence of breast cancer. All EDs except BN were associated with a higher incidence of respiratory and cervical cancers. AN was associated with a higher incidence of esophageal cancer.http://www.sciencedirect.com/science/article/pii/S2667174325000370Anorexia nervosaBreastBulimia nervosaCancerIncidenceRespiratory |
| spellingShingle | Gabrielle E. Cooper Natalie M. Papini Katrine Holde Cynthia M. Bulik Zeynep Yilmaz Liselotte V. Petersen Eating Disorders and Later Incidence of Cancer: A Nationwide Longitudinal Study in Denmark Biological Psychiatry Global Open Science Anorexia nervosa Breast Bulimia nervosa Cancer Incidence Respiratory |
| title | Eating Disorders and Later Incidence of Cancer: A Nationwide Longitudinal Study in Denmark |
| title_full | Eating Disorders and Later Incidence of Cancer: A Nationwide Longitudinal Study in Denmark |
| title_fullStr | Eating Disorders and Later Incidence of Cancer: A Nationwide Longitudinal Study in Denmark |
| title_full_unstemmed | Eating Disorders and Later Incidence of Cancer: A Nationwide Longitudinal Study in Denmark |
| title_short | Eating Disorders and Later Incidence of Cancer: A Nationwide Longitudinal Study in Denmark |
| title_sort | eating disorders and later incidence of cancer a nationwide longitudinal study in denmark |
| topic | Anorexia nervosa Breast Bulimia nervosa Cancer Incidence Respiratory |
| url | http://www.sciencedirect.com/science/article/pii/S2667174325000370 |
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