title: Increased risk for urological cancer associated with anxiety disorder: a retrospective cohort study.
abstract: BACKGROUND
  Anxiety disorders (ADs) are common with a high rate of medical comorbidities. Although the association between ADs and the overall cancer risk remains controversial, patients with ADs were found to be more likely to develop specific cancer types. Herein, we estimated the risk of developing urological cancers among patients with ADs in a 5-year follow-up period using a population-based database.
  
  
  METHODS
  Two study cohorts were identified from the Taiwan Longitudinal Health Insurance Database 2005: patients with ADs, and comparison subjects selected by one-to-one matching for sex, age, and the year of recruitment. Follow-up was undertaken to determine whether sampled patients and comparison subjects had developed urological cancers in the subsequent 5 years.
  
  
  RESULTS
  We found that urological cancers occurred among 0.54% of patients with ADs and 0.13% of comparison subjects. After adjusting for sociodemographic characteristics, medical comorbidities, and alcohol and tobacco use disorder, the stratified Cox proportional hazard regression suggested that patients with ADs were more likely to develop urological cancers relative to comparison subjects (adjusted hazard ratio, 3.67; 95% confidence interval, 2.85 ~ 4.72). The adjusted HR for males with ADs was 3.82 (95% CI: 2.79 ~ 5.23) in comparison to males without ADs. In addition, the adjusted HR for females with ADs was 3.47 (95% CI: 2.26 ~ 5.31) than those females without ADs.
  
  
  CONCLUSIONS
  We concluded that during the 5-year follow-up period, there was a significantly increased risk of urological cancers among patients with ADs.
authors.affiliation: Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
authors.forename: Yung-Chan
authors.initials: YC
authors.lastname: Chen
authors.affiliation: Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Li-Ting
authors.initials: LT
authors.lastname: Kao
authors.affiliation: Sleep Research Center, Taipei Medical University, Taipei, Taiwan.
authors.forename: Herng-Ching
authors.initials: HC
authors.lastname: Lin
authors.affiliation: Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.|Sleep Research Center, Taipei Medical University, Taipei, Taiwan.|Department of Psychiatry and Medical Humanities, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Hsin-Chien
authors.initials: HC
authors.lastname: Lee
authors.affiliation: School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chung-Chien
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Sleep Research Center, Taipei Medical University, Taipei, Taiwan. chungshiudong@gmail.com.|Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan. chungshiudong@gmail.com.|Graduate Program in Biomedical Informatics, College of Informatics, Yuan-Ze University, Chung-Li, Taiwan. chungshiudong@gmail.com.|Department of Surgery, Far Eastern Memorial Hospital, No.21, Sec. 2, Nanya S. Rd., Banciao Dist, New Taipei City, 220, Taiwan. chungshiudong@gmail.com.
authors.forename: Shiu-Dong
authors.initials: SD
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000150:complications*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D014571:Urologic Neoplasms / Q000453:epidemiology* / Q000209:etiology*
keywords: Anxiety disorder; Bladder cancer; Epidemiology; Urological cancer