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We conducted a nationwide cohort study including 167,836 individuals with a first-onset stress-related disorder (including post-traumatic stress disorder, acute stress reaction, adjustment disorder and other stress reactions) diagnosed between 1981 and 2016 in Sweden (i.e., exposed patients), 1,631,801 birth year- and sex-matched unexposed individuals, and 179,209 unaffected full siblings of the exposed patients. Cox models were used to estimate the hazard ratios (HRs) of newly diagnosed cancer and cancer-related death, beyond 1 year after diagnosis of stress-related disorders. We further examined the potential mediation roles of behavior-related morbidities in the associations of stress-related disorders with smoking or alcohol-related cancer incidence and mortality. We found modestly elevated risks of cancer incidence and mortality among exposed patients compared with matched unexposed individuals (incidence: HR\u2009=\u20091.03, 95% CI 1.01\u20131.06; mortality: HR\u2009=\u20091.13, 95% CI 1.07\u20131.18), while not when comparing with full siblings (incidence: HR\u2009=\u20091.03, 95% CI 0.99\u20131.08; mortality: HR\u2009=\u20091.09, 95% CI 1.00-1.19). Similarly, the suggested elevations in incidence and mortality of individual cancer sites (or groups) in the population-based comparison attenuated towards null in the between-sibling comparison. The risk elevations for smoking or alcohol-related cancers in the population-based comparison (incidence: HR\u2009=\u20091.18, 95% CI 1.11\u20131.24; mortality: HR\u2009=\u20091.20, 95% CI 1.12\u20131.29) were partially mediated by alcohol-related morbidities during follow-up. Collectively, our findings suggest that the association between stress-related disorders and cancer risk and mortality is largely explained by familial factors, including shared behavioral hazards.<\/jats:p>","DOI":"10.1007\/s10654-022-00898-x","type":"journal-article","created":{"date-parts":[[2022,8,13]],"date-time":"2022-08-13T08:02:45Z","timestamp":1660377765000},"page":"947-958","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Stress-related disorders and subsequent cancer risk and mortality: a population-based and sibling-controlled cohort study in Sweden"],"prefix":"10.1007","volume":"37","author":[{"given":"Fan","family":"Tian","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weimin","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Unnur A.","family":"Valdimarsd\u00f3ttir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3845-8079","authenticated-orcid":false,"given":"Huan","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,8,13]]},"reference":[{"issue":"8","key":"898_CR1","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1038\/ncponc1134","volume":"5","author":"Y Chida","year":"2008","unstructured":"Chida Y, Hamer M, Wardle J, Steptoe A. 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