TOPLINE:

Mental health conditions (MHCs) such as depression, anxiety, and bipolar disorders were associated with increased risks for overall and site-specific cancers, according to a population-based study.

METHODOLOGY:

• Researchers conducted a population-based prospective cohort study of 39,304 cases of MHCs from participants in the UK Biobank database between 2006 and 2010.
• MHCs, including depressive disorders (6.4%), anxiety disorders (5.4%), bipolar disorders (0.4%), schizophrenia (0.4%), and posttraumatic stress disorder (0.1%), were identified through confirmed diagnoses in linked inpatient hospital admission records. The severity of depression and anxiety was assessed using the four-item Patient Health Questionnaire (PHQ-4).
• Participants were followed up for a median of 13.4 years, during which 68,065 incident cancer cases were recorded in eight sites: breast, ovary, uterus, prostate, lung, blood, colorectum, and liver.
• Associations between MHCs and the incidence of cancer were evaluated, with three incrementally adjusted Cox models accounting for sociodemographic, health-related, and lifestyle or behavioural factors.

TAKEAWAY:

• Depressive disorders were associated with an increased risk for overall cancer (hazard ratio [HR], 1.13; P < .001), with similar associations observed for anxiety disorders (HR, 1.15; P < .001) and bipolar disorders (HR, 1.22; P = .01). No significant associations were observed for schizophrenia and posttraumatic stress disorder.
• Sex-stratified analyses revealed that associations of depressive disorders (HR, 1.27; 95% CI, 1.18-1.35) and bipolar disorders (HR, 1.54; 95% CI, 1.26-1.88) with the risk for overall cancer were significant only in men.
• For site-specific cancers, depressive and anxiety disorders showed the strongest associations with liver, blood, and lung cancers, and anxiety disorders were also associated with prostate cancer.
• A dose-response relationship was observed in sensitivity analyses, with each unit increase in the PHQ-4 symptom score associated with an increased risk for overall cancer (HR, 1.03; 95% CI, 1.02-1.04) and an elevated risk for prostate, lung, blood, and liver cancers.

IN PRACTICE:

"While causality cannot be assumed, diagnoses of MHCs could be useful for cancer risk stratification, as these individuals might represent a high-risk group," the authors wrote, adding that "the findings reinforce the need to support healthy lifestyles among people with MHCs."

SOURCE:

This study was led by Mohammed Sherif Amin, Department of Clinical Infection, Microbiology, and Immunology, The University of Liverpool, Liverpool, England. It was published online on April 28, 2026, in the International Journal of Cancer.

LIMITATIONS:

This study was limited by its observational design; residual or unmeasured confounding; the use of a complete case approach, leading to potential selection bias; non-mutually exclusive diagnoses of MHCs; and self-reported physician diagnoses of MHCs at baseline and from hospital records, potentially leading to the exclusion of less severe cases. Additionally, t he low baseline response rate of the UK Biobank at 5.5% limited the generalisability of the findings.

DISCLOSURES:

No funding information was provided for the study. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.