Evidence map›Paper›PMID 28122812›Full record

SynthesisBMJ (Clinical research ed.)2017

Psychological distress in relation to site specific cancer mortality: pooling of unpublished data from 16 prospective cohort studies.

G David Batty, Tom C Russ, Emmanuel Stamatakis, Mika Kivimäki

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 193 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
193citing papers in PubMed, 11 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

193 citing papers in PubMed, 11 syntheses or guidelines pooled it.

  1. Pooled it
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  11. Distress Management, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology.Journal of the National Comprehensive Cancer Network : JNCCN · 2019
    Guideline
  12. Trial
  13. Trial
  14. Article
  15. When zero isn't nothing: excess zero scores in repeated distress screening of cancer patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
  16. Prognostic significance of dynamic emotional distress during neoadjuvant therapy and surgery for resectable non-small cell lung cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
  17. Review
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  20. Article

133 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

G David BattyDepartment of Epidemiology and Public Health, University College, London, UK david.batty@ucl.ac.uk.
Tom C RussCentre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.
Emmanuel StamatakisCharles Perkins Centre, Faculty of Health Sciences, University of Sydney, Sydney, Australia.
Mika KivimäkiDepartment of Epidemiology and Public Health, University College, London, UK.

Funding

Medical Research Council MR/K013351/1Medical Research Council MR/K026992/1
6 · The paper itself

Abstract

objectiveTo examine the role of psychological distress (anxiety and depression) as a potential predictor of site specific cancer mortality.

designPooling of individual participant data from 16 prospective cohort studies initiated 1994-2008.

settingNationally representative samples drawn from the health survey for England (13 studies) and the Scottish health survey (three studies).

participants163 363 men and women aged 16 or older at study induction, who were initially free of a cancer diagnosis, provided self reported psychological distress scores (based on the general health questionnaire, GHQ-12) and consented to health record linkage.

main outcome measureVital status records used to ascertain death from 16 site specific malignancies; the three Scottish studies also had information on cancer registration (incidence).

resultsThe studies collectively contributed an average of 9.5 years of mortality surveillance during which there were 16 267 deaths (4353 from cancer). After adjustment for age, sex, education, socioeconomic status, body mass index (BMI), and smoking and alcohol intake, and with reverse causality (by left censoring) and missing data (by imputation) taken into account, relative to people in the least distressed group (GHQ-12 score 0-6), death rates in the most distressed group (score 7-12) were consistently raised for cancer of all sites combined (multivariable adjusted hazard ratio 1.32, 95% confidence interval 1.18 to 1.48) and cancers not related to smoking (1.45, 1.23 to 1.71), as well as carcinoma of the colorectum (1.84, 1.21 to 2.78), prostate (2.42, 1.29 to 4.54), pancreas (2.76, 1.47 to 5.19), oesophagus (2.59, 1.34 to 5.00), and for leukaemia (3.86, 1.42 to 10.5). Stepwise associations across the full range of distress scores were observed for colorectal and prostate cancer.

conclusionThis study contributes to the growing evidence that psychological distress might have some predictive capacity for selected cancer presentations, in addition to other somatic diseases.

Indexed as

AdolescentAdultAgedAged, 80 and overAnxietyDepressionEnglandFemaleHealth SurveysHumansMaleMiddle AgedNeoplasmsPrognosisScotlandSelf Report

Identifiers

PMID28122812
PMCPMC5266623

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.