Abstract
PurposeThe association between striking life events, an important stress and acute anxiety disorder, and the occurrence of primary breast cancer is unclear. The current meta-analysis was designed to assess the relationship between striking life events and primary breast cancer incidence in women.MethodsSystematic computerized searching of the PubMed, ScienceDirect, Embase, and BMJ databases with the combinations of controlled descriptors from Mesh, including breast cancer, breast tumor, cancer of breast, mammary carcinoma, life events, life change events, case–control studies, case-base studies, cohort study, and cohort analysis and identified a total of 307 papers published from January 1995 to April 2012. Following evaluation of methodological quality with the Downs & Black criteria, seven case–control or cohort studies were selected and the association between striking life events and primary breast cancer incidence in women was measured using random effect or fixed-effect odds ratios combined with 95% confidence interval.ResultsThe seven studies included in the final meta-analysis included 99,807 women. A meta-analysis showed that the pooled OR for striking life events and breast cancer was 1.51 (95% CI 1.15 - 1.97, P = 0.003), indicating that women with striking life events were at 1.5-fold greater risk of developing breast cancer. The pooled OR for severe striking life events and breast cancer was 2.07 (95% CI 1.06 - 4.03), indicating that women with severe striking life events were at 2-fold greater risk of developing breast cancer.ConclusionsThe current meta-analysis showed significant evidence for a positive association between striking life events and primary breast cancer incidence in women.
Highlights
Primary breast cancer is one of the main public health problems worldwide
An important stress disorder, called striking life events, has been classified as an acute anxiety disorder. This disorder is characterized by aversive anguishing experiences and physiological responses that develop after exposure to stressful life events, including change in marital status, such as separation, divorce, or widowhood; death of a spouse, child, or close relative; a friend’s illness; personal health problems; and change in financial status
We found that the risk of breast cancer was strongly and significantly associated with more severe striking life events, suggesting that individuals with severe striking life events would be at two-fold greater risk of developing breast cancer than individuals without these severe striking life events (Figure 2)
Summary
Primary breast cancer is one of the main public health problems worldwide. Over 1.3 million women are diagnosed annually with primary breast cancer and approximately 458,000 will die from the disease [1]. An important stress disorder, called striking life events, has been classified as an acute anxiety disorder This disorder is characterized by aversive anguishing experiences and physiological responses that develop after exposure to stressful life events, including change in marital status, such as separation, divorce, or widowhood; death of a spouse, child, or close relative; a friend’s illness; personal health problems; and change in financial status. This disorder has short-term features, distinguishing it from chronic or delayed-onset stress disorder [11,12,13]. No case–control or cohort study performed to date has assessed the correlation between short-term exposure to stressful life events and the incidence of primary breast cancer
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