{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T14:33:42Z","timestamp":1790519622189,"version":"4.1.0"},"reference-count":48,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2020,6,26]],"date-time":"2020-06-26T00:00:00Z","timestamp":1593129600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Data on the leading shared risk factors of cancer and mental disorders are limited. We included 98,958 participants (54.8% women) aged 45\u201364 years from the 45 and Up Study who were free of cancer, depression, and anxiety at baseline (2006\u20132009). The incidence of cancer, mental disorders, and multimorbidity (concurrent cancer and mental disorders) was identified using claim databases during follow-up until 31 December 2016. During a nine-year follow-up, the cumulative incidence of cancer, mental disorders, and multimorbidity was 8.8%, 17.4%, and 2.2%, respectively. Participants with cancer were 3.41 times more likely to develop mental disorders, while individuals with mental disorders were 3.06 times more likely to develop cancer than people without these conditions. The shared risk factors for cancer and mental disorders were older age, female gender, smoking, psychological distress, low fruit intake, poor\/fair self-rated health, hypertension, arthritis, asthma, and diabetes. Low education, low income, overweight\/obesity, and family history of depression were risk factors for mental disorders and multimorbidity but not cancer. In conclusion, smoking, low fruit intake, and obesity are key modifiable factors for the prevention of cancer and mental disorders. Individuals with poor\/fair self-rated health, high psychological distress, asthma, hypertension, arthritis, or diabetes should be targeted for the prevention and screening of cancer and mental disorders.<\/jats:p>","DOI":"10.3390\/cancers12061700","type":"journal-article","created":{"date-parts":[[2020,6,30]],"date-time":"2020-06-30T09:36:04Z","timestamp":1593509764000},"page":"1700","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Are Leading Risk Factors for Cancer and Mental Disorders Multimorbidity Shared by These Two Individual Conditions in Community-Dwelling Middle-Aged Adults?"],"prefix":"10.3390","volume":"12","author":[{"given":"Xianwen","family":"Shang","sequence":"first","affiliation":[{"name":"Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC 3002, Australia"},{"name":"School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC 3002, Australia"},{"name":"Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Melbourne, VIC 3050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5464-2197","authenticated-orcid":false,"given":"Allison M.","family":"Hodge","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC 3004, Australia"},{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Peng","sequence":"additional","affiliation":[{"name":"Research Centre for Data Analytics and Cognition, La Trobe University, Melbourne, VIC 3083, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingguang","family":"He","sequence":"additional","affiliation":[{"name":"Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC 3002, Australia"},{"name":"Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC 3002, Australia"},{"name":"State Key Laboratory of Ophthalmology, National Clinical Research Center, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2343-084X","authenticated-orcid":false,"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC 3002, Australia"},{"name":"China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi\u2019an Jiaotong University Health Science Centre, Xi\u2019an 760061, Shaanxi, China"},{"name":"Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC 3053, Australia"},{"name":"Central Clinical School, Faculty of Medicine, Monash University, Melbourne, VIC 3004, Australia"},{"name":"School of Public Health and Preventive Medicine, Faculty of Medicine, Monash University, Melbourne, VIC 3004, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,6,26]]},"reference":[{"key":"ref_1","unstructured":"(2018). Global Burden of Disease Cancer Collaboration. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2016: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol., 4, 1553\u20131568."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1016\/S0140-6736(16)31012-1","article-title":"Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980\u20132015: A systematic analysis for the Global Burden of Disease Study 2015","volume":"388","author":"Wang","year":"2016","journal-title":"Lancet"},{"key":"ref_3","unstructured":"Fitzsimmons, G.J., and Sadkowsky, K.R. (2002). The Australian Institute of Health and Welfare. Commun. Dis. Intell. Q. Rep., 26."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1093\/ije\/dyu038","article-title":"The global prevalence of common mental disorders: A systematic review and meta-analysis 1980\u20132013","volume":"43","author":"Steel","year":"2014","journal-title":"Int. J. Epidemiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1001\/jamapsychiatry.2014.2502","article-title":"Mortality in mental disorders and global disease burden implications: A systematic review and meta-analysis","volume":"72","author":"Walker","year":"2015","journal-title":"JAMA Psychiatry"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/S2215-0366(15)00505-2","article-title":"Estimating the true global burden of mental illness","volume":"3","author":"Vigo","year":"2016","journal-title":"Lancet Psychiatry"},{"key":"ref_7","first-page":"e181","article-title":"Comorbidity, physical and mental health among cancer patients and survivors: An Australian population-based study","volume":"14","author":"Ng","year":"2017","journal-title":"Asia-Pacific J. Clin. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"5349","DOI":"10.1002\/cncr.24561","article-title":"Depression as a predictor of disease progression and mortality in cancer patients","volume":"115","author":"Satin","year":"2009","journal-title":"Cancer"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1200\/JCO.2016.67.7690","article-title":"Use of Medications for Treating Anxiety and Depression in Cancer Survivors in the United States","volume":"35","author":"Hawkins","year":"2017","journal-title":"J. Clin. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1001\/jamapsychiatry.2013.278","article-title":"Cancer-Related Mortality in People With Mental Illness","volume":"70","author":"Kisely","year":"2013","journal-title":"JAMA Psychiatry"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1797","DOI":"10.1017\/S0033291709992285","article-title":"Depression and cancer mortality: A meta-analysis","volume":"40","author":"Pinquart","year":"2010","journal-title":"Psychol. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1784","DOI":"10.1016\/S0140-6736(05)67725-2","article-title":"Causes of cancer in the world: Comparative risk assessment of nine behavioural and environmental risk factors","volume":"366","author":"Danaei","year":"2005","journal-title":"Lancet"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1176\/appi.ajp.160.6.1147","article-title":"Risk Factors for Depression Among Elderly Community Subjects: A Systematic Review and Meta-Analysis","volume":"160","author":"Cole","year":"2003","journal-title":"Am. J. Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1016\/j.jad.2017.09.022","article-title":"Diet quality and depression risk: A systematic review and dose-response meta-analysis of prospective studies","volume":"226","author":"Molendijk","year":"2018","journal-title":"J. Affect. Disord."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Taylor, K., Hadgkiss, E.J., Jelinek, G., Weiland, T., Pereira, N.G., Marck, C.H., and Van Der Meer, D.M. (2014). Lifestyle factors, demographics and medications associated with depression risk in an international sample of people with multiple sclerosis. BMC Psychiatry, 14.","DOI":"10.1186\/s12888-014-0327-3"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"268","DOI":"10.3389\/fgene.2012.00268","article-title":"Gender Differences in Cancer Susceptibility: An Inadequately Addressed Issue","volume":"3","author":"Dorak","year":"2012","journal-title":"Front. Genet."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"80","DOI":"10.21820\/23987073.2018.2.80","article-title":"Australian Institute of Health and Welfare","volume":"2018","author":"Sandison","year":"2018","journal-title":"Impact"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1001\/jamapsychiatry.2014.16","article-title":"A Comprehensive Nationwide Study of the Incidence Rate and Lifetime Risk for Treated Mental Disorders","volume":"71","author":"Pedersen","year":"2014","journal-title":"JAMA Psychiatry"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1177\/070674370404900208","article-title":"Prevalence and Incidence Studies of Mood Disorders: A Systematic Review of the Literature","volume":"49","author":"Waraich","year":"2004","journal-title":"Can. J. Psychiatry"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.puhe.2017.04.026","article-title":"Depression and cancer risk: A systematic review and meta-analysis","volume":"149","author":"Jia","year":"2017","journal-title":"Public Heal."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1001\/jamaoncol.2016.0483","article-title":"Clinical Diagnosis of Mental Disorders Immediately Before and After Cancer Diagnosis","volume":"2","author":"Lu","year":"2016","journal-title":"JAMA Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1097\/PHM.0b013e31829b4afe","article-title":"Cancer Prehabilitation","volume":"92","author":"Silver","year":"2013","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1002\/ijc.23033","article-title":"Tobacco smoking and cancer: A meta-analysis","volume":"122","author":"Gandini","year":"2007","journal-title":"Int. J. Cancer"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2406","DOI":"10.1002\/ijc.24191","article-title":"Cigarette smoking and colorectal cancer incidence and mortality: Systematic review and meta-analysis","volume":"124","author":"Liang","year":"2009","journal-title":"Int. J. Cancer"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1056\/NEJMsr1606602","article-title":"International Agency for Research on Cancer Handbook Working Group Body Fatness and Cancer\u2014Viewpoint of the IARC Working Group","volume":"375","author":"Scoccianti","year":"2016","journal-title":"New Engl. J. Med."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Xu, Y.X.Z., and Mishra, S. (2018). Obesity-Linked Cancers: Current Knowledge, Challenges and Limitations in Mechanistic Studies and Rodent Models. Cancers, 10.","DOI":"10.3390\/cancers10120523"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1002\/ijc.31088","article-title":"How many cancer cases and deaths are potentially preventable? Estimates for Australia in 2013","volume":"142","author":"Wilson","year":"2017","journal-title":"Int. J. Cancer"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Chen, Y., Liu, L., Zhou, Q., Imam, M.U., Cai, J., Wang, Y., Qi, M., Sun, P., Ping, Z., and Fu, X. (2017). Body mass index had different effects on premenopausal and postmenopausal breast cancer risks: A dose-response meta-analysis with 3,318,796 subjects from 31 cohort studies. BMC Public Heal., 17.","DOI":"10.1186\/s12889-017-4953-9"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1093\/jnci\/djq072","article-title":"Fruit and Vegetable Intake and Overall Cancer Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC)","volume":"102","author":"Boffetta","year":"2010","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1001\/jamainternmed.2016.1548","article-title":"Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults","volume":"176","author":"Moore","year":"2016","journal-title":"JAMA Intern. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"7509","DOI":"10.7314\/APJCP.2013.14.12.7509","article-title":"Sleep Duration and Cancer Risk: A Systematic Review and Meta-analysis of Prospective Studies","volume":"14","author":"Zhao","year":"2013","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Wu, S., Wang, R., Zhao, Y., Ma, X., Wu, M., Yan, X., and He, J. (2013). The relationship between self-rated health and objective health status: A population-based study. BMC Public Heal., 13.","DOI":"10.1186\/1471-2458-13-320"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/S0895-4356(01)00491-7","article-title":"Self-rated health, chronic diseases, and symptoms among middle-aged and elderly men and women","volume":"55","author":"Molarius","year":"2002","journal-title":"J. Clin. Epidemiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1136\/jech.2006.047308","article-title":"The relative impact of 13 chronic conditions across three different outcomes","volume":"61","author":"Perruccio","year":"2007","journal-title":"J. Epidemiol. Community Heal."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1007\/s11136-013-0453-2","article-title":"Poor self-rated health associated with an increased risk of subsequent development of lung cancer","volume":"23","author":"Riise","year":"2013","journal-title":"Qual. Life Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.socscimed.2009.05.013","article-title":"What is self-rated health and why does it predict mortality? Towards a unified conceptual model","volume":"69","year":"2009","journal-title":"Soc. Sci. Med."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Batty, G.D., Russ, T.C., Stamatakis, E., and Kivimaki, M. (2017). Psychological distress in relation to site specific cancer mortality: Pooling of unpublished data from 16 prospective cohort studies. BMJ, 356.","DOI":"10.1136\/bmj.j108"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.medici.2016.03.002","article-title":"Hypertension, serum lipids and cancer risk: A review of epidemiological evidence","volume":"52","author":"Everatt","year":"2016","journal-title":"Medicina"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"g7607","DOI":"10.1136\/bmj.g7607","article-title":"Type 2 diabetes and cancer: Umbrella review of meta-analyses of observational studies","volume":"350","author":"Tsilidis","year":"2015","journal-title":"BMJ"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1186\/s13075-015-0728-9","article-title":"Incidence of malignancy in adult patients with rheumatoid arthritis: A meta-analysis","volume":"17","author":"Simon","year":"2015","journal-title":"Arthritis Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e1317","DOI":"10.1097\/MD.0000000000001317","article-title":"Prevalence of Depression in Patients With Hypertension","volume":"94","author":"Li","year":"2015","journal-title":"Medicine"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2480","DOI":"10.1007\/s00125-010-1874-x","article-title":"European Depression in Diabetes (EDID) Research Consortium Type 2 diabetes mellitus as a risk factor for the onset of depression: A systematic review and meta-analysis","volume":"53","author":"Nouwen","year":"2010","journal-title":"Diabetologia"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1093\/ageing\/afw001","article-title":"Prevalence of depressive symptoms and anxiety in osteoarthritis: A systematic review and meta-analysis","volume":"45","author":"Stubbs","year":"2016","journal-title":"Age Ageing"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.socscimed.2014.10.039","article-title":"The socioeconomic gradient in physical inactivity: Evidence from one million adults in England","volume":"123","author":"Farrell","year":"2014","journal-title":"Soc. Sci. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1097\/01.ede.0000220549.14177.60","article-title":"Does Low Participation in Cohort Studies Induce Bias?","volume":"17","author":"Nohr","year":"2006","journal-title":"Epidemiology"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Mealing, N.M., Banks, E., Jorm, L., Steel, D., Clements, M.S., and Rogers, K. (2010). Investigation of relative risk estimates from studies of the same population with contrasting response rates and designs. BMC Med Res. Methodol., 10.","DOI":"10.1186\/1471-2288-10-26"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"45 and Up Study Collaborators, Banks, E., Redman, S., Jorm, L., Armstrong, B., Bauman, A., Beard, J., Beral, V., Byles, J., and Corbett, S. (2007). Cohort profile: The 45 and up study. Int. J. Epidemiol., 37, 941\u2013947.","DOI":"10.1093\/ije\/dym184"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1056\/NEJMp1606181","article-title":"Predicting the Future\u2014Big Data, Machine Learning, and Clinical Medicine","volume":"375","author":"Obermeyer","year":"2016","journal-title":"New Engl. J. Med."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/12\/6\/1700\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:43:12Z","timestamp":1760175792000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/12\/6\/1700"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,26]]},"references-count":48,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,6]]}},"alternative-id":["cancers12061700"],"URL":"https:\/\/doi.org\/10.3390\/cancers12061700","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,26]]}}}