Association of Anorexia Nervosa With Risk of Cancer: A Systematic Review and Meta-analysis

Anorexia nervosa is recognized as an important cause of morbidity in young people. However, the risk of cancer in people with anorexia nervosa remains uncertain. To evaluate the association of anorexia nervosa with the risk of developing or dying of cancer. MEDLINE, Scopus, Embase, and Web of Scienc...

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Bibliographic Details
Published in:JAMA network open 2019-06, Vol.2 (6), p.e195313-e195313
Main Authors: Catalá-López, Ferrán, Forés-Martos, Jaume, Driver, Jane A, Page, Matthew J, Hutton, Brian, Ridao, Manuel, Alonso-Arroyo, Adolfo, Macías Saint-Gerons, Diego, Gènova-Maleras, Ricard, Valderas, José M, Vieta, Eduard, Valencia, Alfonso, Tabarés-Seisdedos, Rafael
Format: Article
Language:English
Subjects:
Adult
Aged
Anorexia
Anorexia Nervosa - complications
Breast cancer
Epidemiologic Methods
Esophageal cancer
Female
Humans
Lung cancer
Male
Meta-analysis
Middle Aged
Mortality
Neoplasms - etiology
Neoplasms - mortality
Oncology
Online Only
Original Investigation
Sex Distribution
Young Adult
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Summary:Anorexia nervosa is recognized as an important cause of morbidity in young people. However, the risk of cancer in people with anorexia nervosa remains uncertain. To evaluate the association of anorexia nervosa with the risk of developing or dying of cancer. MEDLINE, Scopus, Embase, and Web of Science from database inception to January 9, 2019. Published observational studies in humans examining the risk of cancer in people with anorexia nervosa compared with the general population or those without anorexia nervosa. Studies needed to report incidence or mortality rate ratios (RRs). Screening, data extraction, and methodological quality assessment were performed by at least 2 researchers independently. A random-effects model was used to synthesize individual studies. Heterogeneity (I2) was assessed and 95% prediction intervals (PIs) were calculated. All cancer incidence and cancer mortality associated with anorexia nervosa. Secondary outcomes were site-specific cancer incidence and mortality. Seven cohort studies published in 10 articles (42 602 participants with anorexia nervosa) were included. Anorexia nervosa was not associated with risk of developing any cancer (4 studies in women; RR, 0.97; 95% CI, 0.89-1.06; P = .53; I2, 0%; 95% PI, 0.80-1.18; moderate confidence). Anorexia nervosa was associated with decreased breast cancer incidence (5 studies in women; RR, 0.60; 95% CI, 0.50-0.80; P 
ISSN:2574-3805
2574-3805
DOI:10.1001/jamanetworkopen.2019.5313