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Breast Cancer Research
Published in: Breast Cancer Research 1/2016

Open Access 01-12-2016 | Research article

Psychological stress, adverse life events and breast cancer incidence: a cohort investigation in 106,000 women in the United Kingdom

Authors: Minouk J. Schoemaker, Michael E. Jones, Lauren B. Wright, James Griffin, Emily McFadden, Alan Ashworth, Anthony J. Swerdlow

Published in: Breast Cancer Research | Issue 1/2016

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Abstract

Background

Women diagnosed with breast cancer frequently attribute their cancer to psychological stress, but scientific evidence is inconclusive. We investigated whether experienced frequency of stress and adverse life events affect subsequent breast cancer risk.

Methods

Breast cancer incidence was analysed with respect to stress variables collected at enrolment in a prospective cohort study of 106,000 women in the United Kingdom, with 1783 incident breast cancer cases. Relative risks (RR) were obtained as hazard ratios using Cox proportional hazards models.

Results

There was no association of breast cancer risk overall with experienced frequency of stress. Risk was reduced for death of a close relative during the 5 years preceding study entry (RR = 0.87, 95 % confidence interval (CI): 0.78–0.97), but not for death of a spouse/partner or close friend, personal illness/injury, or divorce/separation. There was a positive association of divorce with oestrogen-receptor-negative (RR = 1.54, 95 % CI: 1.01–2.34), but not with oestrogen-receptor-positive breast cancer. Risk was raised in women who were under age 20 at the death of their mother (RR = 1.31, 95 % CI: 1.02–1.67), but not of their father, and the effect was attenuated after excluding mothers with breast or ovarian cancer (RR = 1.17, 95 % CI: 0.85–1.61).

Conclusions

This large prospective study did not show consistent evidence for an association of breast cancer risk with perceived stress levels or adverse life events in the preceding 5 years, or loss of parents during childhood and adolescence.
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Literature
1.
Dumalaon-Canaria JA, Hutchinson AD, Prichard I, Wilson C. What causes breast cancer? A systematic review of causal attributions among breast cancer survivors and how these compare to expert-endorsed risk factors. Cancer Causes Control. 2014;25(7):771–85.CrossRefPubMed
2.
Selye H. The stress of life. New York: McGraw-Hill; 1956.
3.
Lazarus R. Patterns of adjustment. New York: McGraw-Hill; 1976.
4.
Ross K. Mapping pathways from stress to cancer progression. J Natl Cancer Inst. 2008;100(13):914–5. 917.CrossRefPubMed
5.
McEwen BS, Gray JD, Nasca C. 60 years of neuroendocrinology: redefining neuroendocrinology: stress, sex and cognitive and emotional regulation. J Endocrinol. 2015;226(2):T67–83.CrossRefPubMedPubMedCentral
6.
Reiche EM, Nunes SO, Morimoto HK. Stress, depression, the immune system, and cancer. Lancet Oncol. 2004;5(10):617–25.CrossRefPubMed
7.
Lutgendorf SK, Sood AK, Anderson B, McGinn S, Maiseri H, Dao M, Sorosky JI, De Geest K, Ritchie J, Lubaroff DM. Social support, psychological distress, and natural killer cell activity in ovarian cancer. J Clin Oncol. 2005;23(28):7105–13.
8.
Hermes GL, Delgado B, Tretiakova M, Cavigelli SA, Krausz T, Conzen SD, McClintock MK. Social isolation dysregulates endocrine and behavioral stress while increasing malignant burden of spontaneous mammary tumors. Proc Natl Acad Sci U S A. 2009;106(52):22393–8.
9.
10.
11.
Kroenke CH, Hankinson SE, Schernhammer ES, Colditz GA, Kawachi I, Holmes MD. Caregiving stress, endogenous sex steroid hormone levels, and breast cancer incidence. Am J Epidemiol. 2004;159(11):1019–27.CrossRefPubMed
12.
Nielsen NR, Gronbaek M. Stress and breast cancer: a systematic update on the current knowledge. Nat Clin Prac Oncol. 2006;3(11):612–20.CrossRef
13.
Schliep KC, Mumford SL, Vladutiu CJ, Ahrens KA, Perkins NJ, Sjaarda LA, Kissell KA, Prasad A, Wactawski-Wende J, Schisterman EF. Perceived stress, reproductive hormones, and ovulatory function: a prospective cohort study. Epidemiology. 2015;26(2):177–84.
14.
15.
Duijts SF, Zeegers MP, Borne BV. The association between stressful life events and breast cancer risk: a meta-analysis. Int J Cancer. 2003;107(6):1023–9.CrossRefPubMed
16.
Petticrew M. Cancer-stress link: the truth. Nurs Times. 1999;95(9):52–3.PubMed
17.
Chida Y, Hamer M, Wardle J, Steptoe A. Do stress-related psychosocial factors contribute to cancer incidence and survival? Nat Clin Pract Oncol. 2008;5(8):466–75.CrossRefPubMed
18.
Lin Y, Wang C, Zhong Y, Huang X, Peng L, Shan G, Wang K, Sun Q. Striking life events associated with primary breast cancer susceptibility in women: a meta-analysis study. J Exp Clin Cancer Res. 2013;32(1):53.
19.
Swerdlow AJ, Jones ME, Schoemaker MJ, Hemming J, Thomas D, Williamson J, Ashworth A. The Breakthrough Generations Study: design of a long-term UK cohort study to investigate breast cancer aetiology. Br J Cancer. 2011;105(7):911–7.
20.
StataCorp, editor. Stata Statistical Software: Release 14. College Station, Texas: StataCorp LP; 2015.
21.
Solutions CI: ACORN; the complete consumer classification. London; 2002.
22.
Lillberg K, Verkasalo PK, Kaprio J, Teppo L, Helenius H, Koskenvuo M. Stress of daily activities and risk of breast cancer: a prospective cohort study in Finland. Int J Cancer. 2001;91(6):888–93.CrossRefPubMed
23.
Surtees PG, Wainwright NW, Luben RN, Khaw KT, Bingham SA. No evidence that social stress is associated with breast cancer incidence. Breast Cancer Res Treat. 2010;120(1):169–74.CrossRefPubMed
24.
Nielsen NR, Zhang ZF, Kristensen TS, Netterstrom B, Schnohr P, Gronbaek M. Self reported stress and risk of breast cancer: prospective cohort study. BMJ. 2005;331(7516):548.CrossRefPubMedPubMedCentral
25.
Helgesson O, Cabrera C, Lapidus L, Bengtsson C, Lissner L. Self-reported stress levels predict subsequent breast cancer in a cohort of Swedish women. Eur J Cancer Prev. 2003;12(5):377–81.CrossRefPubMed
26.
Metcalfe C, Davey Smith G, Macleod J, Hart C. The role of self-reported stress in the development of breast cancer and prostate cancer: a prospective cohort study of employed males and females with 30 years of follow-up. Eur J Cancer. 2007;43(6):1060–5.CrossRefPubMed
27.
Michael YL, Carlson NE, Chlebowski RT, Aickin M, Weihs KL, Ockene JK, Bowen DJ, Ritenbaugh C. Influence of stressors on breast cancer incidence in the Women's Health Initiative. Health Psychol. 2009;28(2):137–46.
28.
Chen CC, David AS, Nunnerley H, Michell M, Dawson JL, Berry H, Dobbs J, Fahy T. Adverse life events and breast cancer: case-control study. BMJ. 1995;311(7019):1527–30.
29.
Kruk J, Aboul-Enein HY. Psychological stress and the risk of breast cancer: a case-control study. Cancer Detect Prev. 2004;28(6):399–408.CrossRefPubMed
30.
31.
Kruk J. Self-reported psychological stress and the risk of breast cancer: a case-control study. Stress. 2012;15(2):162–71.CrossRefPubMed
32.
Kvikstad A, Vatten LJ, Tretli S, Kvinnsland S. Death of a husband or marital divorce related to risk of breast cancer in middle-aged women. A nested case-control study among Norwegian women born 1935-1954. Eur J Cancer. 1994;30A(4):473–7.CrossRefPubMed
33.
Kvikstad A, Vatten LJ. Risk and prognosis of cancer in middle-aged women who have experienced the death of a child. Int J Cancer. 1996;67(2):165–9.CrossRefPubMed
34.
35.
Li J, Johansen C, Hansen D, Olsen J. Cancer incidence in parents who lost a child: a nationwide study in Denmark. Cancer. 2002;95(10):2237–42.CrossRefPubMed
36.
Lambe M, Cerrato R, Askling J, Hsieh CC. Maternal breast cancer risk after the death of a child. Int J Cancer. 2004;110(5):763–6.CrossRefPubMed
37.
Lillberg K, Verkasalo PK, Kaprio J, Teppo L, Helenius H, Koskenvuo M. Stressful life events and risk of breast cancer in 10,808 women: a cohort study. Am J Epidemiol. 2003;157(5):415–23.CrossRefPubMed
38.
Collins LC, Marotti JD, Gelber S, Cole K, Ruddy K, Kereakoglow S, Brachtel EF, Schapira L, Come SE, Winer EP, et al. Pathologic features and molecular phenotype by patient age in a large cohort of young women with breast cancer. Breast Cancer Res Treat. 2012;131(3):1061–6.
39.
40.
McLaughlin KA, Conron KJ, Koenen KC, Gilman SE. Childhood adversity, adult stressful life events, and risk of past-year psychiatric disorder: a test of the stress sensitization hypothesis in a population-based sample of adults. Psychol Med. 2010;40(10):1647–58.CrossRefPubMed
41.
Stein DJ, Scott K, Haro Abad JM, Aguilar-Gaxiola S, Alonso J, Angermeyer M, Demytteneare K, de Girolamo G, Iwata N, Posada-Villa J, et al. Early childhood adversity and later hypertension: data from the World Mental Health Survey. Ann Clin Psychiatry. 2010;22(1):19–28.
42.
Danese A, McEwen BS. Adverse childhood experiences, allostasis, allostatic load, and age-related disease. Physiol Behav. 2012;106(1):29–39.CrossRefPubMed
43.
Jacobs JR, Bovasso GB. Early and chronic stress and their relation to breast cancer. Psychol Med. 2000;30(3):669–78.CrossRefPubMed
44.
Lokugamage AU, Hotopf M, Hardy R, Mishra G, Butterworth S, Wadsworth ME, Kuh D. Breast cancer in relation to childhood parental divorce and early adult psychiatric disorder in a British birth cohort. Psychol Med. 2006;36(9):1307–12.
45.
Hemminki K, Granstrom C, Czene K. Attributable risks for familial breast cancer by proband status and morphology: a nationwide epidemiologic study from Sweden. Int J Cancer. 2002;100(2):214–9.CrossRefPubMed
Metadata
Title
Psychological stress, adverse life events and breast cancer incidence: a cohort investigation in 106,000 women in the United Kingdom
Authors
Minouk J. Schoemaker
Michael E. Jones
Lauren B. Wright
James Griffin
Emily McFadden
Alan Ashworth
Anthony J. Swerdlow
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Breast Cancer Research / Issue 1/2016
Electronic ISSN: 1465-542X
DOI
https://doi.org/10.1186/s13058-016-0733-1

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