1
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Basten M, Pan KY, van Tuijl LA, de Graeff A, Dekker J, Hoogendoorn AW, Lamers F, Ranchor AV, Vermeulen R, Portengen L, Voogd AC, Abell J, Awadalla P, Beekman ATF, Bjerkeset O, Boyd A, Cui Y, Frank P, Galenkamp H, Garssen B, Hellingman S, Huisman M, Huss A, Keats MR, Kok AAL, Krokstad S, van Leeuwen FE, Luik AI, Noisel N, Payette Y, Penninx BWJH, Rissanen I, Roest AM, Rosmalen JGM, Ruiter R, Schoevers RA, Soave D, Spaan M, Steptoe A, Stronks K, Sund ER, Sweeney E, Twait EL, Teyhan A, Verschuren WMM, van der Willik KD, Geerlings MI. Psychosocial factors, health behaviors and risk of cancer incidence: Testing interaction and effect modification in an individual participant data meta-analysis. Int J Cancer 2024; 154:1745-1759. [PMID: 38289012 DOI: 10.1002/ijc.34852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 11/30/2023] [Accepted: 12/04/2023] [Indexed: 03/14/2024]
Abstract
Depression, anxiety and other psychosocial factors are hypothesized to be involved in cancer development. We examined whether psychosocial factors interact with or modify the effects of health behaviors, such as smoking and alcohol use, in relation to cancer incidence. Two-stage individual participant data meta-analyses were performed based on 22 cohorts of the PSYchosocial factors and CAncer (PSY-CA) study. We examined nine psychosocial factors (depression diagnosis, depression symptoms, anxiety diagnosis, anxiety symptoms, perceived social support, loss events, general distress, neuroticism, relationship status), seven health behaviors/behavior-related factors (smoking, alcohol use, physical activity, body mass index, sedentary behavior, sleep quality, sleep duration) and seven cancer outcomes (overall cancer, smoking-related, alcohol-related, breast, lung, prostate, colorectal). Effects of the psychosocial factor, health behavior and their product term on cancer incidence were estimated using Cox regression. We pooled cohort-specific estimates using multivariate random-effects meta-analyses. Additive and multiplicative interaction/effect modification was examined. This study involved 437,827 participants, 36,961 incident cancer diagnoses, and 4,749,481 person years of follow-up. Out of 744 combinations of psychosocial factors, health behaviors, and cancer outcomes, we found no evidence of interaction. Effect modification was found for some combinations, but there were no clear patterns for any particular factors or outcomes involved. In this first large study to systematically examine potential interaction and effect modification, we found no evidence for psychosocial factors to interact with or modify health behaviors in relation to cancer incidence. The behavioral risk profile for cancer incidence is similar in people with and without psychosocial stress.
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Affiliation(s)
- Maartje Basten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health program, Amsterdam, The Netherlands
- Amsterdam Public Health, Health Behaviors and Chronic Diseases program, Amsterdam, The Netherlands
| | - Kuan-Yu Pan
- Amsterdam Public Health, Mental Health program, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lonneke A van Tuijl
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - Alexander de Graeff
- Department of Medical Oncology, University Medical Center Utrecht, The Netherlands
| | - Joost Dekker
- Amsterdam Public Health, Mental Health program, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Adriaan W Hoogendoorn
- Amsterdam Public Health, Mental Health program, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Femke Lamers
- Amsterdam Public Health, Mental Health program, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Adelita V Ranchor
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Lützen Portengen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Adri C Voogd
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands
| | - Jessica Abell
- Department of Behavioural Science and Health, University College London, London, UK
| | - Philip Awadalla
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Aartjan T F Beekman
- Amsterdam Public Health, Mental Health program, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ottar Bjerkeset
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
- Faculty of Medicine and Health Sciences, Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Andy Boyd
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Yunsong Cui
- Atlantic Partnership for Tomorrow's Health, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Philipp Frank
- Department of Behavioural Science and Health, University College London, London, UK
| | - Henrike Galenkamp
- Department of Public and Occupational Health, Amsterdam UMC, and Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - Bert Garssen
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sean Hellingman
- Department of Mathematics, Wilfrid Laurier University, Waterloo, Canada
| | - Martijn Huisman
- Department of Epidemiology & Data Science, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Aging & Later Life, Amsterdam, The Netherlands
| | - Anke Huss
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Melanie R Keats
- School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Almar A L Kok
- Amsterdam Public Health, Mental Health program, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Epidemiology & Data Science, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Aging & Later Life, Amsterdam, The Netherlands
| | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Norway
- Levanger hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Flora E van Leeuwen
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | | | | | - Brenda W J H Penninx
- Amsterdam Public Health, Mental Health program, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ina Rissanen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Annelieke M Roest
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| | - Judith G M Rosmalen
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Rikje Ruiter
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Maasstad, Rotterdam, The Netherlands
| | - Robert A Schoevers
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - David Soave
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
- Department of Mathematics, Wilfrid Laurier University, Waterloo, Canada
| | - Mandy Spaan
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Karien Stronks
- Department of Public and Occupational Health, Amsterdam UMC, and Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
- Center for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Erik R Sund
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Norway
- Levanger hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Ellen Sweeney
- Atlantic Partnership for Tomorrow's Health, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Emma L Twait
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Alison Teyhan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - W M Monique Verschuren
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Kimberly D van der Willik
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - Mirjam I Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
- Amsterdam Public Health, Aging & Later Life, Amsterdam, The Netherlands
- Department of General Practice, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Personalized Medicine, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, and Mood, Anxiety, Psychosis, Stress, and Sleep, Amsterdam, The Netherlands
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2
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Pan KY, van Tuijl L, Basten M, Rijnhart JJM, de Graeff A, Dekker J, Geerlings MI, Hoogendoorn A, Ranchor AV, Vermeulen R, Portengen L, Voogd AC, Abell J, Awadalla P, Beekman ATF, Bjerkeset O, Boyd A, Cui Y, Frank P, Galenkamp H, Garssen B, Hellingman S, Hollander M, Huisman M, Huss A, Keats MR, Kok AAL, Krokstad S, van Leeuwen FE, Luik AI, Noisel N, Payette Y, Penninx BWJH, Picavet S, Rissanen I, Roest AM, Rosmalen JGM, Ruiter R, Schoevers RA, Soave D, Spaan M, Steptoe A, Stronks K, Sund ER, Sweeney E, Teyhan A, Twait EL, van der Willik KD, Lamers F. The mediating role of health behaviors in the association between depression, anxiety and cancer incidence: an individual participant data meta-analysis. Psychol Med 2024:1-14. [PMID: 38680088 DOI: 10.1017/s0033291724000850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
BACKGROUND Although behavioral mechanisms in the association among depression, anxiety, and cancer are plausible, few studies have empirically studied mediation by health behaviors. We aimed to examine the mediating role of several health behaviors in the associations among depression, anxiety, and the incidence of various cancer types (overall, breast, prostate, lung, colorectal, smoking-related, and alcohol-related cancers). METHODS Two-stage individual participant data meta-analyses were performed based on 18 cohorts within the Psychosocial Factors and Cancer Incidence consortium that had a measure of depression or anxiety (N = 319 613, cancer incidence = 25 803). Health behaviors included smoking, physical inactivity, alcohol use, body mass index (BMI), sedentary behavior, and sleep duration and quality. In stage one, path-specific regression estimates were obtained in each cohort. In stage two, cohort-specific estimates were pooled using random-effects multivariate meta-analysis, and natural indirect effects (i.e. mediating effects) were calculated as hazard ratios (HRs). RESULTS Smoking (HRs range 1.04-1.10) and physical inactivity (HRs range 1.01-1.02) significantly mediated the associations among depression, anxiety, and lung cancer. Smoking was also a mediator for smoking-related cancers (HRs range 1.03-1.06). There was mediation by health behaviors, especially smoking, physical inactivity, alcohol use, and a higher BMI, in the associations among depression, anxiety, and overall cancer or other types of cancer, but effects were small (HRs generally below 1.01). CONCLUSIONS Smoking constitutes a mediating pathway linking depression and anxiety to lung cancer and smoking-related cancers. Our findings underline the importance of smoking cessation interventions for persons with depression or anxiety.
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Affiliation(s)
- Kuan-Yu Pan
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health, Mental Health program, Amsterdam, the Netherlands
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lonneke van Tuijl
- Health Psychology Section, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands
| | - Maartje Basten
- Amsterdam Public Health, Mental Health program, Amsterdam, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health, Health Behaviors and Chronic Diseases program, Amsterdam, the Netherlands
| | | | - Alexander de Graeff
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Joost Dekker
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health, Mental Health program, Amsterdam, the Netherlands
| | - Mirjam I Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
- Department of General Practice, Amsterdam UMC, location UvA, Amsterdam, the Netherlands
- Amsterdam Public Health, Aging & Later Life, and Personalized Medicine, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, and Mood, Anxiety, Psychosis, Stress, and Sleep, Amsterdam, the Netherlands
| | - Adriaan Hoogendoorn
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Adelita V Ranchor
- Health Psychology Section, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Lützen Portengen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Adri C Voogd
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands
| | - Jessica Abell
- Department of Behavioral Science and Health, University College London, London, UK
| | - Philip Awadalla
- Ontario Institute for Cancer Research, Toronto, ON, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Aartjan T F Beekman
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ottar Bjerkeset
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
| | - Andy Boyd
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Yunsong Cui
- Atlantic Partnership for Tomorrow's Health, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Philipp Frank
- Department of Behavioral Science and Health, University College London, London, UK
| | - Henrike Galenkamp
- Amsterdam Public Health, Health Behaviors and Chronic Diseases program, Amsterdam, the Netherlands
- Department of Public and Occupational Health, location University of Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Bert Garssen
- Health Psychology Section, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Sean Hellingman
- Department of Mathematics, Wilfrid Laurier University, Waterloo, Canada
| | - Monika Hollander
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Martijn Huisman
- Department of Epidemiology & Data Science, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Anke Huss
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Melanie R Keats
- Faculty of Health, School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Almar A L Kok
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Epidemiology & Data Science, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Steinar Krokstad
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Flora E van Leeuwen
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands
| | - Nolwenn Noisel
- CARTaGENE, CHU Sainte-Justine, 3175, Chemin de la Côte-Sainte-Catherine, Montréal, QC, Canada
| | - Yves Payette
- CARTaGENE, CHU Sainte-Justine, 3175, Chemin de la Côte-Sainte-Catherine, Montréal, QC, Canada
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health, Mental Health program, Amsterdam, the Netherlands
| | - Susan Picavet
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Utrecht Bilthoven, the Netherlands
| | - Ina Rissanen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Annelieke M Roest
- Department of Developmental Psychology, University of Groningen, Groningen, the Netherlands
| | - Judith G M Rosmalen
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Rikje Ruiter
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Maasstad Hospital, Rotterdam, the Netherlands
| | - Robert A Schoevers
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - David Soave
- Ontario Institute for Cancer Research, Toronto, ON, Canada
- Department of Mathematics, Wilfrid Laurier University, Waterloo, Canada
| | - Mandy Spaan
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Andrew Steptoe
- Department of Behavioral Science and Health, University College London, London, UK
| | - Karien Stronks
- Department of Public and Occupational Health, location University of Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
- Center for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands
| | - Erik R Sund
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Ellen Sweeney
- Atlantic Partnership for Tomorrow's Health, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Alison Teyhan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Emma L Twait
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
- Amsterdam Public Health, Aging & Later Life, and Personalized Medicine, Amsterdam, the Netherlands
- Department of General Practice, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Kimberly D van der Willik
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands
| | - Femke Lamers
- Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health, Mental Health program, Amsterdam, the Netherlands
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3
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van Tuijl LA, Basten M, Pan KY, Vermeulen R, Portengen L, de Graeff A, Dekker J, Geerlings MI, Hoogendoorn A, Lamers F, Voogd AC, Abell J, Awadalla P, Beekman ATF, Bjerkeset O, Boyd A, Cui Y, Frank P, Galenkamp H, Garssen B, Hellingman S, Huisman M, Huss A, de Jong TR, Keats MR, Kok AAL, Krokstad S, van Leeuwen FE, Luik AI, Noisel N, Onland-Moret NC, Payette Y, Penninx BWJH, Rissanen I, Roest AM, Ruiter R, Schoevers RA, Soave D, Spaan M, Steptoe A, Stronks K, Sund ER, Sweeney E, Twait EL, Teyhan A, Verschuren WMM, van der Willik KD, Rosmalen JGM, Ranchor AV. Depression, anxiety, and the risk of cancer: An individual participant data meta-analysis. Cancer 2023; 129:3287-3299. [PMID: 37545248 DOI: 10.1002/cncr.34853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/16/2023] [Accepted: 04/07/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Depression and anxiety have long been hypothesized to be related to an increased cancer risk. Despite the great amount of research that has been conducted, findings are inconclusive. To provide a stronger basis for addressing the associations between depression, anxiety, and the incidence of various cancer types (overall, breast, lung, prostate, colorectal, alcohol-related, and smoking-related cancers), individual participant data (IPD) meta-analyses were performed within the Psychosocial Factors and Cancer Incidence (PSY-CA) consortium. METHODS The PSY-CA consortium includes data from 18 cohorts with measures of depression or anxiety (up to N = 319,613; cancer incidences, 25,803; person-years of follow-up, 3,254,714). Both symptoms and a diagnosis of depression and anxiety were examined as predictors of future cancer risk. Two-stage IPD meta-analyses were run, first by using Cox regression models in each cohort (stage 1), and then by aggregating the results in random-effects meta-analyses (stage 2). RESULTS No associations were found between depression or anxiety and overall, breast, prostate, colorectal, and alcohol-related cancers. Depression and anxiety (symptoms and diagnoses) were associated with the incidence of lung cancer and smoking-related cancers (hazard ratios [HRs], 1.06-1.60). However, these associations were substantially attenuated when additionally adjusting for known risk factors including smoking, alcohol use, and body mass index (HRs, 1.04-1.23). CONCLUSIONS Depression and anxiety are not related to increased risk for most cancer outcomes, except for lung and smoking-related cancers. This study shows that key covariates are likely to explain the relationship between depression, anxiety, and lung and smoking-related cancers. PREREGISTRATION NUMBER: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=157677.
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Affiliation(s)
- Lonneke A van Tuijl
- Health Psychology Section, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands
| | - Maartje Basten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Kuan-Yu Pan
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Mental Health Program, Amsterdam Public Health, Amsterdam, the Netherlands
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Lützen Portengen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Alexander de Graeff
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Joost Dekker
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Mental Health Program, Amsterdam Public Health, Amsterdam, the Netherlands
| | - Mirjam I Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
- Department of General Practice, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Aging & Later Life and Personalized Medicine, Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Neurodegeneration and Mood, Anxiety, Psychosis, Stress, and Sleep, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Adriaan Hoogendoorn
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands
| | - Femke Lamers
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Mental Health Program, Amsterdam Public Health, Amsterdam, the Netherlands
| | - Adri C Voogd
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organization, Utrecht, the Netherlands
| | - Jessica Abell
- Department of Behavioural Science and Health, University College London, London, UK
| | - Philip Awadalla
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Aartjan T F Beekman
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ottar Bjerkeset
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Andy Boyd
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Yunsong Cui
- Atlantic Partnership for Tomorrow's Health, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Philipp Frank
- Department of Behavioural Science and Health, University College London, London, UK
| | - Henrike Galenkamp
- Department of Public and Occupational Health, Amsterdam UMC, and Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, the Netherlands
| | - Bert Garssen
- Health Psychology Section, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Sean Hellingman
- Department of Mathematics, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Martijn Huisman
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Anke Huss
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | | | - Melanie R Keats
- School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Almar A L Kok
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Steinar Krokstad
- Department of Public Health and Nursing, Trøndelag Health Study Research Centre, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Flora E van Leeuwen
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands
| | | | - N Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Yves Payette
- CARTaGENE, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ina Rissanen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Annelieke M Roest
- Department of Developmental Psychology, University of Groningen, Groningen, the Netherlands
| | - Rikje Ruiter
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Maasstad, Rotterdam, the Netherlands
| | - Robert A Schoevers
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - David Soave
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
- Department of Mathematics, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Mandy Spaan
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Karien Stronks
- Department of Public and Occupational Health, Amsterdam UMC, and Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, the Netherlands
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands
| | - Erik R Sund
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
- Department of Public Health and Nursing, Trøndelag Health Study Research Centre, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Ellen Sweeney
- Atlantic Partnership for Tomorrow's Health, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Emma L Twait
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
- Department of General Practice, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Aging & Later Life and Personalized Medicine, Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Alison Teyhan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - W M Monique Verschuren
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Utrecht Bilthoven, the Netherlands
| | - Kimberly D van der Willik
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands
| | - Judith G M Rosmalen
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Adelita V Ranchor
- Health Psychology Section, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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4
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Müller F, Veen LM, Galenkamp H, Jim HSL, Lok A, Nieuwkerk PT, Suurmond J, van Laarhoven HWM, Knoop H. Emotional distress in cancer survivors from various ethnic backgrounds: Analysis of the multi-ethnic HELIUS study. Psychooncology 2023; 32:1412-1423. [PMID: 37482911 DOI: 10.1002/pon.6192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 06/07/2023] [Accepted: 07/05/2023] [Indexed: 07/25/2023]
Abstract
PURPOSE Insight into emotional distress of cancer survivors from ethnic minority groups in Europe is scarce. We aimed to compare distress levels of survivors from ethnic minorities to that of the majority population, determine whether the association between having cancer (yes vs. no) and distress differs among ethnic groups and investigate sociocultural correlates of distress. METHODS Cross-sectional data were derived from HELIUS, a multi-ethnic cohort study conducted in the Netherlands. Of 19,147 participants, 351 were diagnosed with cancer (n = 130 Dutch, n = 75 African Surinamese, n = 53 South-Asian Surinamese, n = 43 Moroccan, n = 28 Turkish, n = 22 Ghanaian). Distress (PHQ-9, MCS-12) and correlates were assessed by self-report. Cancer-related variables were derived from the Netherlands Cancer Registry. RESULTS Survivors were on average 7 years post-diagnosis. Survivors from South-Asian Surinamese, Moroccan, Turkish and Ghanaian origin reported more distress than survivors from Dutch origin (effect sizerange : 0.44-1.17; adjusted models). The association between having cancer or not with distress differed in direction between Dutch and the non-Dutch ethnic groups: Non-Dutch cancer patients tended to have more distress than their cancer-free peers, whereas Dutch cancer patients tended to have less distress than their cancer-free peers. For Moroccan and Turkish patients, the acculturation style of separation/marginalization, compared to integration/assimilation, was associated with higher depressive symptoms. In analyses pooling data from all ethnic minorities, lower health literacy, lower emotional support satisfaction and younger age at the time of migration were associated with higher depressive symptoms. Lower health literacy, fewer emotional support transactions, and more frequent attendance at religious services were associated with worse mental health. CONCLUSION Cancer survivors from ethnic minorities experience more distress than those from the majority population. Culturally sensitive supportive care should be considered.
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Affiliation(s)
- Fabiola Müller
- Medical Psychology, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health, Global Health, Amsterdam, the Netherlands
- Amsterdam Public Health, Mental Health, Amsterdam, the Netherlands
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - Linde M Veen
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
- Department of Medical Oncology, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
| | - Henrike Galenkamp
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, the Netherlands
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Anja Lok
- Amsterdam Public Health, Mental Health, Amsterdam, the Netherlands
- Department of Psychiatry, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Stress & Sleep, Amsterdam, the Netherlands
| | - Pythia T Nieuwkerk
- Medical Psychology, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health, Personalized Medicine, Amsterdam, the Netherlands
- Amsterdam Public Health, Aging & Later Life, Amsterdam, the Netherlands
- Amsterdam Institute for Infection and Immunity, Inflammatory Diseases, Amsterdam, the Netherlands
| | - Jeanine Suurmond
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health, Personalized Medicine, Amsterdam, the Netherlands
| | - Hanneke W M van Laarhoven
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
- Department of Medical Oncology, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
| | - Hans Knoop
- Medical Psychology, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health, Mental Health, Amsterdam, the Netherlands
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Expert Center for Chronic Fatigue, Amsterdam, the Netherlands
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5
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Yan T, Zhu S, Xie C, Chen X, Zhu M, Weng F, Wang C, Guo C. Dissecting the Association of Genetically Predicted Neuroticism with Coronary Artery Disease: A Two-Sample Mendelian Randomization Study. J Pers Med 2022; 12:288. [PMID: 35207779 PMCID: PMC8877774 DOI: 10.3390/jpm12020288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/10/2022] [Accepted: 02/14/2022] [Indexed: 12/04/2022] Open
Abstract
Background: Observational studies on the association between neuroticism and coronary artery disease (CAD) are still rare, and the results of existing studies are not consistent. The present study aimed to explore causal associations of neuroticism with CAD. Methods: The summary-level data of GWAS for neuroticism and 12 items used to assess neuroticism were extracted from the UK Biobank, and included up to 380,506 participants. The general data for CAD were obtained from the CARDIoGRAMplusC4D consortium, which assembled 60,801 CAD patients and 123,504 non-cases. Single-nucleotide polymorphisms associated with neuroticism and 12 items at genome-wide significance were explored as instrumental variables. Two-sample Mendelian randomization (TSMR) analyses were performed to evaluate causal associations amongst the genetically predicted neuroticism and 12 items with CAD. Results: The present TSMR study did not reveal the genetic association of neuroticism with CAD. The calculated ORs for CAD using inverse-variance weighted, weighted median, and MR-Egger analysis were 1.12 (p-value = 0.187), 0.99 (p-value = 0.943), and 0.82 (p-value = 0.683), respectively. Further TSMR analysis of 12 dichotomous items for assessing neuroticism suggested that mood swings genetically increased the risk of CAD (OR = 1.67, p-value < 0.001). Conclusions: This study reported no genetically causal association of neuroticism with CAD. The present study also found that mood swings may genetically increase the risk of CAD. These findings may highlight the potential of mood control as a preventive measure for CAD.
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6
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van Tuijl LA, Voogd AC, de Graeff A, Hoogendoorn AW, Ranchor AV, Pan KY, Basten M, Lamers F, Geerlings MI, Abell JG, Awadalla P, Bakker MF, Beekman ATF, Bjerkeset O, Boyd A, Cui Y, Galenkamp H, Garssen B, Hellingman S, Huisman M, Huss A, Keats MR, Kok AAL, Luik AI, Noisel N, Onland-Moret NC, Payette Y, Penninx BWJH, Portengen L, Rissanen I, Roest AM, Rosmalen JGM, Ruiter R, Schoevers RA, Soave DM, Spaan M, Steptoe A, Stronks K, Sund ER, Sweeney E, Teyhan A, Vaartjes I, van der Willik KD, van Leeuwen FE, van Petersen R, Verschuren WMM, Visseren F, Vermeulen R, Dekker J. Psychosocial factors and cancer incidence (PSY-CA): Protocol for individual participant data meta-analyses. Brain Behav 2021; 11:e2340. [PMID: 34473425 PMCID: PMC8553309 DOI: 10.1002/brb3.2340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 08/12/2021] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES Psychosocial factors have been hypothesized to increase the risk of cancer. This study aims (1) to test whether psychosocial factors (depression, anxiety, recent loss events, subjective social support, relationship status, general distress, and neuroticism) are associated with the incidence of any cancer (any, breast, lung, prostate, colorectal, smoking-related, and alcohol-related); (2) to test the interaction between psychosocial factors and factors related to cancer risk (smoking, alcohol use, weight, physical activity, sedentary behavior, sleep, age, sex, education, hormone replacement therapy, and menopausal status) with regard to the incidence of cancer; and (3) to test the mediating role of health behaviors (smoking, alcohol use, weight, physical activity, sedentary behavior, and sleep) in the relationship between psychosocial factors and the incidence of cancer. METHODS The psychosocial factors and cancer incidence (PSY-CA) consortium was established involving experts in the field of (psycho-)oncology, methodology, and epidemiology. Using data collected in 18 cohorts (N = 617,355), a preplanned two-stage individual participant data (IPD) meta-analysis is proposed. Standardized analyses will be conducted on harmonized datasets for each cohort (stage 1), and meta-analyses will be performed on the risk estimates (stage 2). CONCLUSION PSY-CA aims to elucidate the relationship between psychosocial factors and cancer risk by addressing several shortcomings of prior meta-analyses.
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Affiliation(s)
- Lonneke A van Tuijl
- Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands
| | - Adri C Voogd
- Department of Internal Medicine, Division of Medical Oncology, GROW, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Epidemiology, GROW, Maastricht University, Maastricht, The Netherlands.,Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands
| | - Alexander de Graeff
- Department of Medical Oncology, Cancer Center University Medical Center, University of Utrecht, Utrecht, The Netherlands
| | - Adriaan W Hoogendoorn
- Amsterdam UMC, Department of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands.,GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Adelita V Ranchor
- Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands
| | - Kuan-Yu Pan
- Amsterdam UMC, Department of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Maartje Basten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Femke Lamers
- Amsterdam UMC, Department of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Mirjam I Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Jessica G Abell
- Department of Behavioural Science and Health, University College London, London, UK
| | - Philip Awadalla
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Marije F Bakker
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Aartjan T F Beekman
- Amsterdam UMC, Department of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Ottar Bjerkeset
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.,Faculty of Medicine and Health Sciences, Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Andy Boyd
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Yunsong Cui
- Atlantic Partnership for Tomorrow's Health, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Henrike Galenkamp
- Department of Public and Occupational Health, Amsterdam UMC, and Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Bert Garssen
- Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands
| | - Sean Hellingman
- Department of Mathematics, Wilfrid Laurier University, Waterloo, Canada
| | - Martijn Huisman
- Amsterdam UMC, Department of Epidemiology & Data Science, Amsterdam Public Health institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anke Huss
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Melanie R Keats
- School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Almar A L Kok
- Amsterdam UMC, Department of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam UMC, Department of Epidemiology & Data Science, Amsterdam Public Health institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - Nolwenn Noisel
- CARTaGENE, CHU Sainte-Justine, 3175, Chemin de la Côte-Sainte-Catherine, Montréal, Québec, Canada
| | - N Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Yves Payette
- CARTaGENE, CHU Sainte-Justine, 3175, Chemin de la Côte-Sainte-Catherine, Montréal, Québec, Canada
| | - Brenda W J H Penninx
- Amsterdam UMC, Department of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Lützen Portengen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Ina Rissanen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Annelieke M Roest
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| | - Judith G M Rosmalen
- Departments of Psychiatry and Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rikje Ruiter
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,Department of Internal Medicine, Maasstad, Rotterdam, The Netherlands
| | - Robert A Schoevers
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - David M Soave
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada.,Department of Mathematics, Wilfrid Laurier University, Waterloo, Canada
| | - Mandy Spaan
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Karien Stronks
- Department of Public and Occupational Health, Amsterdam UMC, and Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Erik R Sund
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.,Department of Public Health and Nursing, HUNT Research Centre, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Levanger hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Ellen Sweeney
- Atlantic Partnership for Tomorrow's Health, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Alison Teyhan
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Ilonca Vaartjes
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Kimberly D van der Willik
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Flora E van Leeuwen
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Rutger van Petersen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - W M Monique Verschuren
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands.,Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Utrecht, the Netherlands
| | - Frank Visseren
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Joost Dekker
- Amsterdam Public Health Research Institute, Amsterdam, Noord-Holland, The Netherlands.,Department of Rehabilitation Medicine and Department of Psychiatry, Amsterdam UMC - VUMC, Amsterdam, Noord-Holland, The Netherlands
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