Work

Eating Disorders and Later Incidence of Cancer: A Nationwide Longitudinal Study in Denmark

Year: 2025

Type: article

Abstract: We examined the incidence of cancer types among individuals with eating disorders (EDs). A nationwide longitudinal study of 6,807,731 individuals born between 1940 and 2015 was conducted using the Danish National Registries. Cox models with ED diagnosis as exposure and cancer diagnoses as outcomes were used to estimate hazard ratios (HRs) and 95% CIs while adjusting for sex, birth year, and comorbidities. The primary analysis comprised ICD-8 and ICD-10 codes for anorexia nervosa (AN) and other ED (OED). The secondary analysis comprised ICD-10 codes and included AN, bulimia nervosa (BN), and eating disorders not otherwise specified (EDNOS). AN was associated with a reduced incidence of breast cancer while adjusting for sex and birth year (HR, 0.80; 95% CI, 0.66–0.97) and elevated incidence of respiratory (HR, 1.59; 95% CI, 1.24–2.04), cervical (HR, 1.45; 95% CI, 1.05–1.98), and esophageal (HR, 4.77; 95% CI, 2.82–8.06) cancers. OED was associated with an elevated incidence of respiratory (HR, 1.57; 95% CI, 1.20–2.06) and cervical (HR, 1.60; 95% CI, 1.20–2.14) cancers. ICD-10–only analyses confirmed the association of AN with reduced incidence of breast cancer and elevated incidence of respiratory and cervical cancers. BN was associated with reduced incidence of breast cancer in sensitivity analysis. EDNOS was associated with reduced incidence of breast cancer and elevated incidence of respiratory and cervical cancers. All EDs were associated with a reduced incidence of breast cancer. All EDs except BN were associated with a higher incidence of respiratory and cervical cancers. AN was associated with a higher incidence of esophageal cancer. Our population-based cohort study analyzes the relationship between eating disorders and the incidence of various types of cancer. The results confirm and expand upon what is known about the risk of breast cancer in individuals with eating disorders. We establish a decreased risk of breast cancer not only in individuals with anorexia nervosa but also in individuals with bulimia nervosa. Furthermore, we demonstrated an increased risk of respiratory, esophageal, and cervical cancer in the eating disorder population. These results shed light on the significant morbidity associated with eating disorders, possibly related to some of the core symptoms of the illnesses.

Source: Biological Psychiatry Global Open Science

DOI: 10.1016/j.bpsgos.2025.100483

Authors: Gabrielle E. Cooper, Natalie M. Papini, Katrine Holde, Cynthia M. Bulik, Zeynep Yilmaz, Liselotte V. Petersen

Institutions: University of North Carolina at Chapel Hill, Northern Arizona University, Aarhus University, Karolinska Institutet

Language: English

Topic: Eating Disorders and Behaviors

Subfield: Clinical Psychology

Field: Psychology

Domain: Social Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,700