Psychologic Distress Related to Mortality for Leukemia, Other Cancer Types

Anxiety, depression, and psychologic distress may be linked to cancer mortality, particularly for patients with leukemia, according to a meta-analysis published in BMJ by G. David Batty, MSc, PhD.

Dr. Batty and co-authors from the Department of Epidemiology and Public Health at University College London analyzed 16 independent, cross-sectional, prospective, cohort studies conducted between 1994 and 2008, comprising 163,363 adult patients who completed questionnaires on general and mental health.

The authors then compared mortality outcomes between “most-distressed” patients (defined as scores of 7-12 on the General Health Questionnaire 12 [GHQ-12]) and “least-distressed” patients (defined as scores of 0-6 on the GHQ-12).

After a mean follow-up of 9.5 years, researchers reported a total of 16,267 deaths (4,353 from cancer). After controlling for age, sex, socioeconomic status, body mass index, education, and smoking and alcohol intake, the mortality rates in the most-distressed group were consistently higher across all cancer types combined, compared with the least-distressed group (hazard ratio [HR] = 1.32; 95% CI 1.28-1.48).

The associations were strongest for:

  • leukemia: HR=3.86 (95% CI 1.42-10.5)
  • pancreatic cancer: HR=2.76 (95% CI 1.47-5.19)
  • esophageal cancer: HR=2.59 (95% 1.34-5.00)

“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,” the authors concluded.

Source: Batty GD, Russ TC, Stamatakis E, Kivimäki M. Psychological distress in relation to site specific cancer mortality: pooling of unpublished data from 16 prospective cohort studies. BMJ. 2017 January 25. [Epub ahead of print]