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Posttraumatic stress disorder and cancer risk: a nationwide cohort study


The association between stress and cancer incidence has been studied for more than seven decades. Despite plausible biological mechanisms and evidence from laboratory studies, findings from clinical research are conflicting. The objective of this study was to examine the association between PTSD and various cancer outcomes. This nation-wide cohort study included all Danish-born residents of Denmark from 1995 to 2011. The exposure was PTSD diagnoses (n = 4131). The main outcomes were cancer diagnoses including: (1) all malignant neoplasms; (2) hematologic malignancies; (3) immune-related cancers; (4) smoking- and alcohol-related cancers; (5) cancers at all other sites. Standardized incidence ratios (SIR) were calculated. Null associations were found between PTSD and nearly all cancer diagnoses examined, both overall [SIR for all cancers = 1.0, 95 % confidence interval (CI) = 0.88, 1.2] and in analyses stratified by gender, age, substance abuse history and time since PTSD diagnosis. This study is the most comprehensive examination to date of PTSD as a predictor of many cancer types. Our data show no evidence of an association between PTSD and cancer in this nationwide cohort.

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  1. Additional ICD diagnostic criteria for PTSD include the traumatic event being exceptionally threatening or catastrophic in nature, which is likely to cause pervasive distress in almost anyone; persistent re-experience of the event or distress when exposed to reminders of the event; avoidance of things associated with the event; and symptoms of hyperarousal, all within 6 months of the event.


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This work was supported by a National Institute of Mental Health (1R21MH094551-01A1).

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Correspondence to Jaimie L. Gradus.



See Table 3.

Table 3 ICD codes for analytic variables

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Gradus, J.L., Farkas, D.K., Svensson, E. et al. Posttraumatic stress disorder and cancer risk: a nationwide cohort study. Eur J Epidemiol 30, 563–568 (2015).

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