The effects of anxiety on the receipt of treatments for esophageal cancer

Objective: This study aimed to evaluate the association between anxiety and receipt of treatments for esophageal cancer. Methods: We used a population-based cohort to obtain information of patients with esophageal cancer. Baseline diagnoses of depression or anxiety were identified. Competing risk analyses were used to estimate hazard ratios for risk factors affecting the receipt of anticancer therapies. Subanalysis for the association of anxiety and anticancer therapy stratified by covariates were also performed. Results: Ten thousand five hundred thirty-seven patients with esophageal cancer were identified. Seven hundred thirty-two patients (6.9%) had anxiety disorder before the diagnosis of esophageal cancer. Competing risk model showed that having anxiety disorder was positively associated with the receipt of anticancer treatments (hazard ratio 1.12, 95% CI 1.03–1.22, P =.011), while having depression did not affect patients' status of receiving treatments (hazard ratio 1.05, 95% CI 0.93–1.19, P =.462). Besides, older age, female gender, lower income, and having comorbidities of chronic renal failure and liver cirrhosis were associated with a decreased possibility of receiving anticancer therapy. Conclusions: Our results indicate that esophageal cancer patient with anxiety disorder has higher possibility to receive anticancer therapy than patients without anxiety disorder.