Table 4.
Adjusted direct and indirect associations of stress-related disorders on smoking or alcohol-related cancer incidence and mortality mediated via new onset of smoking or alcohol-related morbidities during follow-up, in the population-matched cohorta
| Smoking or alcohol-related cancer incidence | Smoking or alcohol-related cancer mortality | |
|---|---|---|
| HR (95% CI) | HR (95% CI) | |
| Smoking-related morbidities | ||
| Total effect | 1.173 (1.112,1.239) | 1.150 (1.071,1.235) |
| Direct effect | 1.173 (1.112,1.238) | 1.143 (1.064,1.228) |
| Indirect effect | 1.000 (1.000,1.001) | 1.006 (1.005,1.007) |
| Proportion mediated, % | 0.06 | 4.63 |
| Alcohol-related morbidities | ||
| Total effect | 1.154 (1.094,1.218) | 1.152 (1.073,1.237) |
| Direct effect | 1.118 (1.058,1.181) | 1.089 (1.013,1.170) |
| Indirect effect | 1.033 (1.026,1.040) | 1.058 (1.048,1.070) |
| Proportion mediated, % | 23.80 | 41.78 |
a Adjusted for matching variables (birth year and sex), as well as educational level, family income level, marital status, family history of cancer, Charlson comorbidity index, and history of substance use disorders