{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T02:17:18Z","timestamp":1771035438433,"version":"3.50.1"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T00:00:00Z","timestamp":1682035200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003625","name":"Ministry of Health and Welfare","doi-asserted-by":"publisher","award":["grant number: HI18C1140"],"award-info":[{"award-number":["grant number: HI18C1140"]}],"id":[{"id":"10.13039\/501100003625","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Purpose<\/jats:title><jats:p>To investigate the association between insomnia and the risk of various cancers using the Korean National Health Insurance Service database.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Materials and methods<\/jats:title><jats:p>Patients who underwent a national health examination in 2009 were followed-up until 2018. Newly-diagnosed cancers were collected one year after the baseline. Insomnia was defined as having a diagnosis of F510 or G470 within one year prior to enrollment. The incidence of various cancers was compared between patients with and without insomnia.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>In the overall study population (N = 3,982,012), the risk for any type of cancer was not different between controls and insomnia patients (adjusted hazard ratio [aHR]: 0.990). However, it was different by age; insomnia increased the risk of any cancer in younger age groups (20\u201339y and 40\u201359y, aHR:1.310 and 1.139, respectively) but it significantly decreased the risk in the 60\u201379y age group (aHR: 0.939). In cancer type, colorectal cancer risk was lower (aHR: 0.872,<jats:italic>P<\/jats:italic>&lt; 0.0001), whereas leukemia risk was higher (aHR: 1.402,<jats:italic>P<\/jats:italic>&lt; 0.0001) in patients with insomnia than in those without it, regardless of sex. In men, the risk of stomach cancer was lower (aHR: 0.882,<jats:italic>P<\/jats:italic>= 0.0003), and the risks of lung (aHR:1.114,<jats:italic>P<\/jats:italic>= 0.0005), kidney (aHR 1.226,<jats:italic>P<\/jats:italic>= 0.0107), and prostate (aHR:1.101,<jats:italic>P<\/jats:italic>= 0.0028) cancers were higher in insomnia patients than in control patients. In women, insomnia patients compared to control patients showed a lower risk of ovarian cancer (aHR:0.856,<jats:italic>P<\/jats:italic>= 0.0344, respectively), while they had a higher risk of oral (aHR:1.616,<jats:italic>P<\/jats:italic>= 0.002), thyroid (aHR:1.072,<jats:italic>P<\/jats:italic>= 0.0192), and nerve (aHR: 1.251,<jats:italic>P<\/jats:italic>= 0.016) cancers.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusion<\/jats:title><jats:p>Insomnia is associated with an increased or decreased risk of some cancers, depending on age, cancer type and sex.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0284494","type":"journal-article","created":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T17:29:39Z","timestamp":1682098179000},"page":"e0284494","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":23,"title":["Risk of cancer in patients with insomnia: Nationwide retrospective cohort study (2009\u20132018)"],"prefix":"10.1371","volume":"18","author":[{"given":"Kichul","family":"Yoon","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2265-9845","authenticated-orcid":true,"given":"Cheol Min","family":"Shin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6096-1263","authenticated-orcid":true,"given":"Kyungdo","family":"Han","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8920-8777","authenticated-orcid":true,"given":"Jin Hyung","family":"Jung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eun Hyo","family":"Jin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joo Hyun","family":"Lim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung Joo","family":"Kang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoon Jin","family":"Choi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong Ho","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,4,21]]},"reference":[{"key":"pone.0284494.ref001","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.smrv.2018.10.006","article-title":"Insomnia as a predictor of mental disorders: A systematic review and meta-analysis","volume":"43","author":"E Hertenstein","year":"2019","journal-title":"Sleep Med Rev"},{"issue":"1","key":"pone.0284494.ref002","doi-asserted-by":"crossref","first-page":"e12876","DOI":"10.1111\/jsr.12876","article-title":"Does insomnia predict a high risk of cancer? A systematic review and meta-analysis of cohort studies","volume":"29","author":"T Shi","year":"2020","journal-title":"J Sleep Res"},{"key":"pone.0284494.ref003","doi-asserted-by":"crossref","first-page":"101215","DOI":"10.1016\/j.smrv.2019.101215","article-title":"Insomnia and risk of mortality from all-cause, cardiovascular disease, and cancer: Systematic review and meta-analysis of prospective cohort studies","volume":"48","author":"L Ge","year":"2019","journal-title":"Sleep Med Rev"},{"issue":"6","key":"pone.0284494.ref004","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.5664\/jcsm.7172","article-title":"Insomnia in the Elderly: A Review","volume":"14","author":"D Patel","year":"2018","journal-title":"J Clin Sleep Med"},{"issue":"6","key":"pone.0284494.ref005","first-page":"592","volume":"69","author":"T Roth","year":"2011","journal-title":"Prevalence and perceived health associated with insomnia based on DSM-IV-TR; international statistical classification of diseases and related health problems, tenth revision; and research diagnostic criteria\/international classification of sleep disorders, criteria: results from the America insomnia survey"},{"issue":"2","key":"pone.0284494.ref006","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.sleep.2005.08.008","article-title":"Epidemiology of insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors","volume":"7","author":"CM Morin","year":"2006","journal-title":"Sleep Med"},{"issue":"6","key":"pone.0284494.ref007","doi-asserted-by":"crossref","first-page":"533","DOI":"10.30773\/pi.2019.0218","article-title":"The Prevalence and Incidence of Insomnia in Korea during 2005 to 2013","volume":"17","author":"S Chung","year":"2020","journal-title":"Psychiatry Investig"},{"issue":"11","key":"pone.0284494.ref008","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.7150\/jca.12490","article-title":"Risk of Cancer in Patients with Insomnia, Parasomnia, and Obstructive Sleep Apnea: A Nationwide Nested Case-Control Study","volume":"6","author":"H-F Fang","year":"2015","journal-title":"J Cancer"},{"issue":"10","key":"pone.0284494.ref009","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1089\/jwh.2017.6626","article-title":"Insomnia but not hypnotics use associates with the risk of breast cancer: a population-based matched cohort study","volume":"27","author":"H-Y Chiu","year":"2018","journal-title":"J Womens Health (Larchmt)"},{"issue":"4","key":"pone.0284494.ref010","first-page":"461","volume":"79","author":"A Sen","year":"2017","journal-title":"Insomnia and the Risk of Breast Cancer: The HUNT Study"},{"issue":"11","key":"pone.0284494.ref011","first-page":"2204","volume":"141","author":"AJ White","year":"2017","journal-title":"Sleep characteristics, light at night and breast cancer risk in a prospective cohort"},{"key":"pone.0284494.ref012","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.54724\/lc.2022.e1","article-title":"Methods for testing statistical differences between groups in medical research: statistical standard and guideline of Life Cycle Committee","volume":"2","author":"SW Lee","year":"2022","journal-title":"Life Cycle"},{"key":"pone.0284494.ref013","doi-asserted-by":"crossref","first-page":"e3","DOI":"10.54724\/lc.2022.e3","article-title":"Regression analysis for continuous independent variables in medical research: statistical standard and guideline of Life Cycle Committee","volume":"2","author":"SW Lee","year":"2022","journal-title":"Life Cycle"},{"issue":"4","key":"pone.0284494.ref014","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1002\/cncr.25507","article-title":"Short duration of sleep increases risk of colorectal adenoma","volume":"117","author":"CL Thompson","year":"2011","journal-title":"Cancer"},{"issue":"2","key":"pone.0284494.ref015","doi-asserted-by":"crossref","first-page":"573","DOI":"10.21873\/invivo.11513","article-title":"The association between sleep disorders and the risk of colorectal cancer in patients: A Population-based Nested Case\u2013Control Study","volume":"33","author":"C-L Lin","year":"2019","journal-title":"In Vivo"},{"issue":"2","key":"pone.0284494.ref016","doi-asserted-by":"crossref","first-page":"e23424","DOI":"10.5812\/ijhrba.4(2)2015.23424","article-title":"Alcohol Consumption, Depression, Insomnia and Colorectal Cancer Screening: Racial Differences","volume":"4","author":"D Owusu","year":"2015","journal-title":"Int J High Risk Behav Addict"},{"issue":"12","key":"pone.0284494.ref017","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.3748\/wjg.v28.i12.1187","article-title":"Epidemiology of stomach cancer","volume":"28","author":"M Ilic","year":"2022","journal-title":"World journal of gastroenterology"},{"key":"pone.0284494.ref018","doi-asserted-by":"crossref","first-page":"e2020004","DOI":"10.4178\/epih.e2020004","article-title":"Risk factors for stomach cancer: a systematic review and meta-analysis","volume":"42","author":"J Poorolajal","year":"2020","journal-title":"Epidemiology and health"},{"issue":"5","key":"pone.0284494.ref019","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1007\/s10552-022-01565-y","article-title":"Salt intake and gastric cancer: a pooled analysis within the Stomach cancer Pooling (StoP) Project","volume":"33","author":"S Morais","year":"2022","journal-title":"Cancer Causes & Control"},{"issue":"2","key":"pone.0284494.ref020","first-page":"225","article-title":"Association between stress and dietary habits, emotional eating behavior and insomnia of middle-aged men and women in Seoul and Gyeonggi","volume":"15","author":"O Choi","year":"2021","journal-title":"nrp"},{"key":"pone.0284494.ref021","doi-asserted-by":"crossref","first-page":"287","DOI":"10.2147\/IJWH.S197604","article-title":"Ovarian cancer in the world: epidemiology and risk factors","volume":"11","author":"Z Momenimovahed","year":"2019","journal-title":"Int J Womens Health"},{"issue":"5","key":"pone.0284494.ref022","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1054\/bjoc.2000.1596","article-title":"Menstrual and reproductive factors in relation to ovarian cancer risk","volume":"84","author":"L Titus-Ernstoff","year":"2001","journal-title":"British Journal of Cancer"},{"issue":"1","key":"pone.0284494.ref023","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1158\/1940-6207.CAPR-20-0174","article-title":"Sleep Characteristics and Risk of Ovarian Cancer Among Postmenopausal Women","volume":"14","author":"X Liang","year":"2021","journal-title":"Cancer Prevention Research"},{"issue":"1688","key":"pone.0284494.ref024","doi-asserted-by":"crossref","first-page":"20150110","DOI":"10.1098\/rstb.2015.0110","article-title":"Sex differences in sleep: impact of biological sex and sex steroids","volume":"371","author":"JA Mong","year":"2016","journal-title":"Philos Trans R Soc Lond B Biol Sci"},{"issue":"7","key":"pone.0284494.ref025","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1016\/j.sleep.2013.11.782","article-title":"Sleep apnea increased incidence of primary central nervous system cancers: a nationwide cohort study","volume":"15","author":"J-C Chen","year":"2014","journal-title":"Sleep Medicine"},{"issue":"1","key":"pone.0284494.ref026","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1186\/1471-2458-14-295","article-title":"Sleep duration and incidence of lung cancer in ageing men","volume":"14","author":"MK Luojus","year":"2014","journal-title":"BMC Public Health"},{"key":"pone.0284494.ref027","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.sleep.2021.06.044","article-title":"Genetically predicted insomnia and lung cancer risk: a Mendelian randomization study","volume":"87","author":"Z Huo","year":"2021","journal-title":"Sleep Medicine"},{"issue":"Supplement_1","key":"pone.0284494.ref028","doi-asserted-by":"crossref","first-page":"4786","DOI":"10.1182\/blood-2019-125147","article-title":"Sleep Disturbance Among Patients with Myelodysplastic Syndromes and Acute Leukemia","volume":"134","author":"M Luskin","year":"2019","journal-title":"Blood"},{"issue":"11","key":"pone.0284494.ref029","first-page":"e225","volume":"3","author":"N Beerenwinkel","year":"2007","journal-title":"Genetic progression and the waiting time to cancer"},{"key":"pone.0284494.ref030","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.smrv.2016.01.003","article-title":"Qualitative studies of insomnia: Current state of knowledge in the field","volume":"31","author":"T Ara\u00fajo","year":"2017","journal-title":"Sleep Med Rev"},{"key":"pone.0284494.ref031","first-page":"321","volume":"131","author":"Pigeon WRJTIjomr","year":"2010","journal-title":"Diagnosis, prevalence, pathways, consequences & treatment of insomnia"},{"issue":"7","key":"pone.0284494.ref032","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1038\/s41380-019-0595-x","article-title":"Depression and anxiety in relation to cancer incidence and mortality: a systematic review and meta-analysis of cohort studies","volume":"25","author":"YH Wang","year":"2020","journal-title":"Molecular psychiatry"},{"issue":"7","key":"pone.0284494.ref033","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1016\/S0272-7358(00)00083-0","article-title":"INSOMNIA: SYMPTOM OR DIAGNOSIS?","volume":"21","author":"AG Harvey","year":"2001","journal-title":"Clinical Psychology Review"},{"issue":"1","key":"pone.0284494.ref034","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.smrv.2009.07.007","article-title":"The role of personality traits in insomnia","volume":"14","author":"M van de Laar","year":"2010","journal-title":"Sleep Medicine Reviews"},{"issue":"27","key":"pone.0284494.ref035","first-page":"1977","volume":"329","author":"SJ Winawer","year":"1993","journal-title":"Prevention of colorectal cancer by colonoscopic polypectomy"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0284494","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T06:14:00Z","timestamp":1702275240000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0284494"}},"subtitle":[],"editor":[{"given":"Dong Keon","family":"Yon","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2023,4,21]]},"references-count":35,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4,21]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0284494","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,21]]}}}