The Risk of Cancer in Patients with Generalized Anxiety Disorder: A Nationwide Population-Based Study

Cheng Che Shen, Yu Wen Hu, Li Yu Hu, Man Hsin Hung, Tung Ping Su, Min Wei Huang, Chia Fen Tsai, Shuo Ming Ou, Sang Hue Yen, Cheng Hwai Tzeng, Tzeon Jye Chiou, Tzeng Ji Chen, Chia Jen Liu

Research output: Contribution to journalArticlepeer-review

21 Citations (Scopus)


Objective: To evaluate the risk of cancer among patients with generalized anxiety disorder (GAD) in a nationwide population-based dataset. Methods: We recruited newly-diagnosed GAD patients aged 20 years or older without antecedent cancer from the Taiwan National Health Insurance Research database between 2000-2010. Standardized incidence ratios (SIRs) of cancers were calculated in GAD patients, and the subgroup of GAD patients diagnosed by psychiatric specialists. Results: A total of 559 cancers developed among 19,793 GAD patients with a follow-up of 89,485 person-years (median follow-up of 4.34 years), leading to a significantly increased SIR of 1.14 [95% confidence interval (CI) 1.05-1.24]. Male GAD patients had a significantly increased SIR overall (1.30, 95% CI 1.15-1.46) and for lung and prostate cancer (1.77, 95% CI 1.33-2.30 and 2.17, 95% CI 1.56-2.93, respectively). Patients over 80 years of age also had a significantly increased SIR (1.56, 95% CI 1.25-1.92), especially in males. However, psychiatrist-diagnosed GAD patients did not show increased cancer risk relative to the general population, perhaps due to having fewer physical comorbidities than non-psychiatrist-diagnosed GAD patients. Conclusion: This study found that overall cancer risk is elevated among patients with GAD. The risk of lung and prostate cancer also increased in male patients with GAD. This increased cancer risk may be due to physical comorbidities and surveillance bias. Further prospective study is necessary to confirm these findings.

Original languageEnglish
Article numbere57399
JournalPLoS ONE
Issue number2
Publication statusPublished - Feb 27 2013
Externally publishedYes

ASJC Scopus subject areas

  • General Biochemistry,Genetics and Molecular Biology
  • General Agricultural and Biological Sciences
  • General


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