Association of Anorexia Nervosa With Risk of Cancer

Catalá-López, Ferrán; Forés-Martos, Jaume; Driver, Jane A.; Page, Matthew J.; Hutton, Brian; Ridao, Manuel; Alonso-Arroyo, Adolfo; Saint-Gerons, Diego Macías; Gènova-Maleras, Ricard; Valderas, José M; Vieta, Eduard; Valencia, Alfonso; Tabarés‐Seisdedos, Rafael

doi:10.1001/jamanetworkopen.2019.5313

Cited by 12 publications

(11 citation statements)

References 50 publications

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“…In addition, women with previous ED have had a worse prognosis of breast cancer than population comparisons (Bens et al, 2018). Among people with AN, risk of developing cancer did not differ from the comparisons in the general population, however, a significantly reduced risk of breast cancer was observed, compared with the comparisons in the general population (Catala‐Lopez et al, 2019).…”

Section: Introductionmentioning

confidence: 78%

Eating disorders and the risk of esophageal and stomach cancers‐A nationwide, population‐based cohort study in Taiwan

Yeh

Chien

Chung

et al. 2020

Intl J Eating Disorders

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Background: Previous studies have shown elevated cancer risk in anorexia nervosa but the literature on other eating disorders (EDs) is scarce. This study aimed to investigate the association between all EDs and esophageal, stomach, and other cancers.Methods: We used a retrospective cohort design, based on a two-million randomized longitudinal health insurance dataset, a sub-dataset of Taiwan's National Health Insurance Research Database. From all the potential participants aged 20 years or more, a total of 6,628 participants were enrolled, including 1,657 patients with EDs, with sex-, age-, and indexed date-matched (1:3) 4,971 controls. Each participant was individually tracked from 2000 to 2015 to identify incident cases of cancers, including esophageal cancer (EC), stomach cancer (SC), and all other cancers (AOC). The multivariate Cox proportional hazards model was employed to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between EDs and cancer.Results: Of the total 6,628 enrollees, 222 in 1,657 individuals with EDs and 810 in the 4,971 non-ED control individuals developed cancer (1,262.40 vs. 1,472.15 per 100,000 person-years), and the Kaplan-Meier survival analysis was not statistically significant (log-rank, p = .324). However, after adjusting for covariates, the risk of EC and SC among the individuals with an ED was significantly higher, with adjusted HRs of 5.32 (95% CI: 1.07-26.49, p < .001) and 4.61 (95% CI: 1.91-11.14, p < .001), respectively. EDs were not associated with other cancers. Conclusions:This study provides evidence for the association between EDs and the risk for EC and SC. Further research on mechanisms and prevention is therefore needed.

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Section: Introductionmentioning

confidence: 78%

Eating disorders and the risk of esophageal and stomach cancers‐A nationwide, population‐based cohort study in Taiwan

Yeh

Chien

Chung

et al. 2020

Intl J Eating Disorders

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“…Our findings are in line with previous research,21 suggesting the wearable activity tracker influenced steps/day. Notably, an additional 500 steps taken per day has been associated with a 10% reduction in CVD event risk43 and in older women, there is evidence that increased light physical activity (measured by accelerometry) is related to a reduction in risk for CHD and CVD 44…”

Section: Discussionmentioning

confidence: 99%

<p>Wearable Technology To Reduce Sedentary Behavior And CVD Risk In Older Adults: A Pilot Randomized Clinical Trial</p>

Roberts

Jaeger

Baptista

et al. 2019

CIA

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BackgroundPhysical exercise is associated with decreased cardiovascular disease (CVD) risk, but recent large-scale trials suggest that exercise alone is insufficient to reduce CVD events in high-risk older adults.PurposeThis pilot randomized clinical trial aimed to collect critical data on feasibility, safety, and protocol integrity necessary to design a fully powered randomized controlled trial (RCT) and evaluate the impact of combining structured exercise with an intervention designed to enhance non-exercise physical activity (EX+NEPA) compared to EX alone.MethodsForty participants aged ≥60 years with moderate-to-high risk of coronary heart disease events were randomly assigned to either the EX+NEPA or EX groups and followed for 20 weeks. Both groups underwent a twice-weekly, 8-week center-based exercise intervention with aerobic and resistance exercises. EX+NEPA group also received a wearable activity tracking device along with behavioral monitoring and feedback throughout the study. Study outcomes were evaluated at 8 and 20 weeks.ResultsData are presented as adjusted mean change of the differences over time with 95% confidence intervals at 20 weeks. Relative to EX, the change in steps/day at 20 weeks was 1994 (−40.27, 4028) higher for EX+NEPA. For sedentary time at close-out, the EX+NEPA group was −6.8 (−45.2, 31.6) min/day relative to EX. The between-group differences for systolic and diastolic blood pressure were −9.9 (−19.6, −0.3) and −1.8 (−6.9, 3.3) mmHg, respectively.ConclusionThe addition of wearable technology intervention appeared to positively influence daily activity patterns and changes in blood pressure – potentially improving risk factors for CVD. A fully powered randomized trial is needed to ultimately test this hypothesis.

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“…It has been suggested that self-induced vomiting in patients with purging type AN could potentially cause esophageal acidic damage similar to that occurring in gastroesophageal reflux disease (GERD), increasing the risk of developing sequelae such as Barrett's esophagus [48] and adenocarcinoma. Although in a systematic review and meta-analysis AN was potentially associated with an increased risk of developing esophageal cancer (two studies in women; RR, 6.10; 95% CI, 2.30-16.18; p < 0.001; I 2 , 0%) [49], the evidence was judged to be of low confidence and there is still uncertainty about the associations and the role of modifiable risk factors such as smoking.…”

Section: Anorexia Nervosamentioning

confidence: 99%

Eating Disorders and Gastrointestinal Diseases

et al. 2019

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Eating disorders (ED) are frequently associated with a wide range of psychiatric or somatic comorbidities. The most relevant ED are anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorders (BED). Patients with ED exhibit both upper and lower gastrointestinal (GI) symptoms. Evidence of alterations throughout the GI tract in ED will be analyzed given the role of the GI tract in food intake and its regulation. It remains a matter of debate whether GI disorders are inherent manifestations of ED or the results of malnutrition occurring from ED. Moreover, recent clinical studies have highlighted the growing role of intestinal microbiota in the pathogenesis of ED, making it possible to hypothesize a modulation of intestinal microbiota as a co-adjuvant to standard therapy. The aim of this review is to analyze the link between ED and GI diseases and to present, where known, the potential key factors underlying these conditions. Conclusions: The presence of GI disorders should be investigated in patients with ED. Screening for ED should also be encouraged in individuals seeking treatment for unexplained GI complaints to better address therapeutic issues that surround these difficult medical conditions. Nutrients 2019, 11, 3038 3 of 17 ED can be associated with anxiety or mood disorders; insomnia; as well as somatic complications such as cardiac alterations, hormonal imbalances and also a wide range of gastrointestinal (GI) symptoms [3].Prevalence estimate of lifetime AN is 0.8% [4]. The overall incidence rate of AN is around 7 per 100,000 persons; however, it is higher in 15-19 year old girls reaching 109.2 cases per 100,000. The incidence is increasing in Italy and other Western countries probably due to earlier diagnosis or earlier onset [5,6].The prevalence of BN is 0.28% [4]. The highest incidence rate of BN is 300 per 100,000 persons in women aged between 16 and 20 [7], although the age at onset is decreasing [5].BED are described in 0.85% of the population [4,8] and are frequently associated with medical comorbidities, especially obesity and its complications such as Type II diabetes mellitus, hypertension, and dyslipidemia [9]. Furthermore, BED may occur in a subset ranging from 27% to 47% in severely obese persons undergoing bariatric surgery [10].The previous edition of DSM (DSM-IV) [11], classified as "Eating Disorders Not Otherwise Specified (EDNOS)", is the ED that does not satisfy all the diagnostic criteria for AN or BN. Previously, EDNOS contained a huge and varied group of individuals and was the most commonly diagnosed ED. However, the DSM-V revised this ED type and called it "Other Specified Feeding or Eating Disorder" (OSFED). Moreover, the DSM-V introduced the definition of Avoidant/restrictive food intake disorder (ARFID) that was distinct from AN and BN in that there is no body image disturbance [2].The first description of AN in the 19th century revealed that the sufferers' reasons for self-starvation generally were strictly connected to inappetence, feelings of fullness and abdominal ...

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Association of Anorexia Nervosa With Risk of Cancer

Abstract: This systematic review and meta-analysis evaluates the association of anorexia nervosa with the cancer incidence and mortality among study populations with anorexia nervosa compared with the general population or those without anorexia nervosa.

Cited by 12 publications

References 50 publications

Eating disorders and the risk of esophageal and stomach cancers‐A nationwide, population‐based cohort study in Taiwan

Eating disorders and the risk of esophageal and stomach cancers‐A nationwide, population‐based cohort study in Taiwan

<p>Wearable Technology To Reduce Sedentary Behavior And CVD Risk In Older Adults: A Pilot Randomized Clinical Trial</p>

Eating Disorders and Gastrointestinal Diseases

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