Risk of cancer in patients with insomnia: Nationwide retrospective cohort study (2009-2018)

Kichul Yoon; Cheol Min Shin; Kyungdo Han; Jin Hyung Jung; Eun Hyo Jin; Joo Hyun Lim; Seung Joo Kang; Yoon Jin Choi; Dong Ho Lee

doi:10.1371/journal.pone.0284494

Risk of cancer in patients with insomnia: Nationwide retrospective cohort study (2009-2018)

PLoS One. 2023 Apr 21;18(4):e0284494. doi: 10.1371/journal.pone.0284494. eCollection 2023.

Authors

Kichul Yoon¹, Cheol Min Shin², Kyungdo Han³, Jin Hyung Jung⁴, Eun Hyo Jin⁵, Joo Hyun Lim⁵, Seung Joo Kang⁵, Yoon Jin Choi⁶, Dong Ho Lee²

Affiliations

¹ Department of Internal Medicine, Seonam Hospital, Seoul, South Korea.
² Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
³ Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea.
⁴ Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
⁵ Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, South Korea.
⁶ Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.

Abstract

Purpose: To investigate the association between insomnia and the risk of various cancers using the Korean National Health Insurance Service database.

Materials and methods: 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.

Results: 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 (20-39y and 40-59y, aHR:1.310 and 1.139, respectively) but it significantly decreased the risk in the 60-79y age group (aHR: 0.939). In cancer type, colorectal cancer risk was lower (aHR: 0.872, P < 0.0001), whereas leukemia risk was higher (aHR: 1.402, P < 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, P = 0.0003), and the risks of lung (aHR:1.114, P = 0.0005), kidney (aHR 1.226, P = 0.0107), and prostate (aHR:1.101, P = 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, P = 0.0344, respectively), while they had a higher risk of oral (aHR:1.616, P = 0.002), thyroid (aHR:1.072, P = 0.0192), and nerve (aHR: 1.251, P = 0.016) cancers.

Conclusion: Insomnia is associated with an increased or decreased risk of some cancers, depending on age, cancer type and sex.

Copyright: © 2023 Yoon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Female
Humans
Incidence
Leukemia*
Male
Retrospective Studies
Risk Factors
Sleep Initiation and Maintenance Disorders* / complications
Sleep Initiation and Maintenance Disorders* / epidemiology
Stomach Neoplasms*

Grants and funding

This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI18C1140). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.