Abstract
BackgroundWomen 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.MethodsBreast 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.ResultsThere 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).ConclusionsThis 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.Electronic supplementary materialThe online version of this article (doi:10.1186/s13058-016-0733-1) contains supplementary material, which is available to authorized users.
Highlights
Women diagnosed with breast cancer frequently attribute their cancer to psychological stress, but scientific evidence is inconclusive
1.7 % had developed breast cancer, 0.7 % had died by this time, 2.6 % were alive and had not completed the questionnaire but their vital and cancer status was available from National Health Service Central Registers (NHSCR), and 0.4 % were lost to follow-up at an earlier date or no follow-up was available
Future studies should investigate stress and adverse events in such earlier time windows, as well as focus on populations for which our data were sparser, i.e. investigate effects of divorce and other adverse events on breast cancer in young, premenopausal women, by breast cancer characteristics. In this large prospective study there was no consistent evidence that self-reported frequency of stress and experience of adverse life events affected subsequent breast cancer risk
Summary
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. Women with breast cancer frequently attribute the origin of their breast cancer, to psychological factors such as stress [1] scientific evidence for this is inconclusive. A Schoemaker et al Breast Cancer Research (2016) 18:72 protective effect of stress on breast cancer risk through suppression of oestrogen secretion has been proposed [11,12,13]. Indirect effects of stress on health and cancer risk, through changes in lifestyle and behaviour, are possible, and stress may render women more susceptible to progression or recurrence of cancer either by affecting recovery or compliance with their treatment
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