title: Cancer incidence and mortality patterns in women with anorexia nervosa.
abstract: Caloric restriction in animals is an effective way to reduce carcinogenesis. Anorexia nervosa (AN) is considered a model of extreme caloric restriction in humans. The aim of our study was to assess cancer incidence and mortality in women with AN. A total of 6,009 women with at least one inpatient treatment for AN during the period 1973-2003 were included in the study. Standardized incidence ratios (SIR) and standardized mortality ratios (SMR) were calculated. Overall, there was no statistically significant difference in cancer incidence compared to women in the general population. At a statistically significant or borderline significant level, a higher incidence for lung cancer and cancer of lymphoid, hematopoietic and related tissue was observed along with a reduced breast cancer incidence. Women with AN had twice as high mortality from cancer in general, and more specifically from melanoma, cancers of genital organs and cancers of ill-defined, secondary and unspecified sites. The increased lung cancer incidence may be due to smoking habits among women with AN. The worse prognosis with higher mortality from melanoma, cancers of genital organs and cancers of ill-defined, secondary and unspecified sites may be explained by AN-specific attitudes toward seeking medical care, adherence to treatment or worse biological precondition due to starvation and cachexia.
authors.affiliation: Department of Neurosciences, Psychiatry, Uppsala University, Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Georgios
authors.initials: G
authors.lastname: Karamanis
authors.forename: Alkistis
authors.initials: A
authors.lastname: Skalkidou
authors.forename: Georgios
authors.initials: G
authors.lastname: Tsakonas
authors.forename: Lena
authors.initials: L
authors.lastname: Brandt
authors.forename: Anders
authors.initials: A
authors.lastname: Ekbom
authors.forename: Lisa
authors.initials: L
authors.lastname: Ekselius
authors.forename: Fotios C
authors.initials: FC
authors.lastname: Papadopoulos
mesh_terms: D000856:Anorexia Nervosa / Q000453:epidemiology* / Q000401:mortality*; D031204:Caloric Restriction / Q000401:mortality / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D009369:Neoplasms / Q000453:epidemiology* / Q000401:mortality*; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
keywords: anorexia nervosa; breast cancer; cancer of lymphoid; cancers of genital organs; cancers of ill-defined; hematopoietic and related tissue; lung cancer; melanoma; secondary and unspecified sites