Anxiety and depression may have a predictive capacity for certain cancer presentations, according to a study published in the BMJ.

David Batty, from the Department of Epidemiology and Public Health at University College in London, UK, and colleagues examined anxiety and depression as a predictor of site-specific cancer mortality using data from 16 prospective cohort studies conducted between 1994 and 2008.

The study included 163,363 men and women older than 16 years of age at baseline who were initially free of a cancer diagnosis. Participants provided self-reported psychological distress scores based on the general health questionnaire (GHQ-12). The investigators measured vital status records to ascertain death from 16 site-specific malignancies. The data were adjusted for age, sex, education, socioeconomic status, BMI, and smoking and alcohol intake.

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The researchers observed 16,267 deaths; 4,353 were from cancer. Compared with participants who had the least distressed GHQ-12 scores (score 0 to 6), participants with the most distressed scores (score 7 to 12) had consistently increased death rates for cancer of all sites (multivariable adjusted hazard ratio [HR], 1.32) and cancers not related to smoking (HR, 1.45).

In addition, participants with the most distressed scores had increased death rates for carcinoma of the colorectum (HR, 1.84), prostate (HR, 2.42), pancreas (HR, 2.76), esophagus (HR 2.59), and leukemia (HR 3.86).

“Our findings could be important in advancing understanding of the role of psychological distress in cancer etiology and cancer progression as investigators attempt to ascertain what role this and other psychological factors (such as psychosocial stress, cognition, personality, life satisfaction) have, if any, in prevention and prognosis,” the study authors wrote.


  1. Batty GD, Russ TC, Stamatakis E, Kivimaki M. Psychological distress in relation to site specific cancer mortality: pooling of unpublished data from 16 prospective cohort studies. BMJ. 2017. doi:10.1136/bmj.j108