title: The risk of cancer in patients with generalized anxiety disorder: a nationwide population-based study.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors: Department of Psychiatry, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan.
authors: Cheng-Che
authors: CC
authors: Shen
authors: Yu-Wen
authors: YW
authors: Hu
authors: Li-Yu
authors: LY
authors: Hu
authors: Man-Hsin
authors: MH
authors: Hung
authors: Tung-Ping
authors: TP
authors: Su
authors: Min-Wei
authors: MW
authors: Huang
authors: Chia-Fen
authors: CF
authors: Tsai
authors: Shuo-Ming
authors: SM
authors: Ou
authors: Sang-Hue
authors: SH
authors: Yen
authors: Cheng-Hwai
authors: CH
authors: Tzeng
authors: Tzeon-Jye
authors: TJ
authors: Chiou
authors: Tzeng-Ji
authors: TJ
authors: Chen
authors: Chia-Jen
authors: CJ
authors: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000150:complications*; D003710:Demography; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000523:psychology; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult