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Psychological distress in relation to site specific cancer mortality: pooling of unpublished data from 16 prospective cohort studies

Batty, GD; Russ, TC; Stamatakis, E; Kivimäki, M; (2017) Psychological distress in relation to site specific cancer mortality: pooling of unpublished data from 16 prospective cohort studies. BMJ , 356 , Article j108. 10.1136/bmj.j108. Green open access

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Abstract

OBJECTIVE:  To examine the role of psychological distress (anxiety and depression) as a potential predictor of site specific cancer mortality. DESIGN:  Pooling of individual participant data from 16 prospective cohort studies initiated 1994-2008. SETTING:  Nationally representative samples drawn from the health survey for England (13 studies) and the Scottish health survey (three studies). PARTICIPANTS:  163 363 men and women aged 16 or older at study induction, who were initially free of a cancer diagnosis, provided self reported psychological distress scores (based on the general health questionnaire, GHQ-12) and consented to health record linkage. MAIN OUTCOME MEASURE:  Vital status records used to ascertain death from 16 site specific malignancies; the three Scottish studies also had information on cancer registration (incidence). RESULTS:  The studies collectively contributed an average of 9.5 years of mortality surveillance during which there were 16 267 deaths (4353 from cancer). After adjustment for age, sex, education, socioeconomic status, body mass index (BMI), and smoking and alcohol intake, and with reverse causality (by left censoring) and missing data (by imputation) taken into account, relative to people in the least distressed group (GHQ-12 score 0-6), death rates in the most distressed group (score 7-12) were consistently raised for cancer of all sites combined (multivariable adjusted hazard ratio 1.32, 95% confidence interval 1.18 to 1.48) and cancers not related to smoking (1.45, 1.23 to 1.71), as well as carcinoma of the colorectum (1.84, 1.21 to 2.78), prostate (2.42, 1.29 to 4.54), pancreas (2.76, 1.47 to 5.19), oesophagus (2.59, 1.34 to 5.00), and for leukaemia (3.86, 1.42 to 10.5). Stepwise associations across the full range of distress scores were observed for colorectal and prostate cancer. CONCLUSION:  This study contributes to the growing evidence that psychological distress might have some predictive capacity for selected cancer presentations, in addition to other somatic diseases.

Type: Article
Title: Psychological distress in relation to site specific cancer mortality: pooling of unpublished data from 16 prospective cohort studies
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bmj.j108
Publisher version: http://dx.doi.org/10.1136/bmj.j108
Language: English
Additional information: This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 3.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/3.0/.
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: http://discovery.ucl.ac.uk/id/eprint/1537638
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