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The association between anxiety and esophageal cancer: A nationwide population-based study
Zhu, Juan1; Zhou, Yueyue2; Ma, Shanrui1; Chen, Ru1; Xie, Shuanghua1; Liu, Zhengkui2; Li, Xinqing1; Wei, Wenqiang1

Objective Research on generalized anxiety disorder (GAD) and its association with esophageal cancer (EC) is sparse. The study aimed to explore the association between GAD and EC. Methods A multicenter, population-based study in high-risk regions for EC (ECHRRs) was conducted from 2017 to 2019. All participants received free endoscopy screening. If the esophageal endoscopy results were suspicious, the pathological biopsy was performed to confirm normal, esophagitis, low-grade intraepithelial neoplasia (LGIN), high-grade intraepithelial neoplasia (HGIN), and EC. Information on participants' exposure to risk factors was collected. GAD was assessed with Generalized Anxiety Disorder Scale-7. Results With esophageal endoscopy, 25,650 participants in ECHRRs were examined, 9586 of whom were suspicious and confirmed by esophageal pathology. The detection rate of EC and precancerous lesions was 6.83% (1751/25,650), with 1377 LGIN (5.37%), 272 HGIN (1.06%), and 102 EC (0.40%) cases. The overall mean GAD score (95% CI) and prevalence among 25,650 participants with endoscopy were 1.96 (1.93-1.99) and 16.90%, respectively. The mean GAD score and prevalence among 9586 participants with pathology were 1.96 (1.91-2.02) and 17.98%, respectively. The mean GAD scores of patients confirmed with normal, esophagitis, LGIN, HGIN, and EC were 1.73 (1.62-1.85), 1.91 (1.85-1.97), 1.94 (1.80-2.08), 3.98 (3.73-4.23). and 2.97 (2.49-3.45), respectively (p < 0.001). The corresponding prevalence of GAD were 5.21%, 18.72%, 17.72%, 43.75%, and 36.27%, respectively (p < 0.001). The age- and gender-adjusted odds ratios (ORs) between GAD and each esophageal lesion type were 1.02 (0.99-1.04), 1.01 (0.98-1.04), 1.27 (1.21-1.33), and 1.16 (1.08-1.24), respectively. The ORs (95% CIs) of the positive associations were 1.08 (1.05-1.12), 1.03 (0.99-1.07), 1.35 (1.29-1.42), and 1.19 (1.10-1.29) after further adjustment for potential confounders (all p < 0.001). Sensitivity analysis showed that the positive association persisted. Conclusions GAD was significantly higher in patients with EC and precancerous lesions. Focusing on and alleviating anxiety in high-risk groups (including patients with HGIN and EC) may be an effective strategy for EC prevention and control. Further prospective studies are warranted to validate the results.

Keywordendoscopy esophageal cancer GAD gastroscopy generalized anxiety disorder health‐ related quality of life high‐ risk regions screening
Source PublicationPSYCHO-ONCOLOGY
Indexed BySCI
Funding ProjectNational Key Research and Development Program (Precision Medicine Research)[2016YFC0901400] ; National Key Research and Development Program (Precision Medicine Research)[2016YFC0901404]
WOS Research AreaOncology ; Psychology ; Biomedical Social Sciences
WOS SubjectOncology ; Psychology ; Psychology, Multidisciplinary ; Social Sciences, Biomedical
WOS IDWOS:000584004100001
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Document Type期刊论文
Corresponding AuthorWei, Wenqiang
Affiliation1.Chinese Acad Med Sci & Peking Union Med Coll, CAMS & PUMC, Natl Clin Res Ctr Canc, Canc Registry Off,Natl Canc Ctr,Canc Hosp, 17 Panjiayuan Nanli, Beijing 100021, Peoples R China
2.Chinese Acad Sci, Inst Psychol, Key Lab Mental Hlth, Beijing, Peoples R China
Recommended Citation
GB/T 7714
Zhu, Juan,Zhou, Yueyue,Ma, Shanrui,et al. The association between anxiety and esophageal cancer: A nationwide population-based study[J]. PSYCHO-ONCOLOGY,2020:10.
APA Zhu, Juan.,Zhou, Yueyue.,Ma, Shanrui.,Chen, Ru.,Xie, Shuanghua.,...&Wei, Wenqiang.(2020).The association between anxiety and esophageal cancer: A nationwide population-based study.PSYCHO-ONCOLOGY,10.
MLA Zhu, Juan,et al."The association between anxiety and esophageal cancer: A nationwide population-based study".PSYCHO-ONCOLOGY (2020):10.
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