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Table 1 Prospective epidemiologic studies looking at the effect of stress on breast cancer risk

From: Stress and breast cancer: from epidemiology to molecular biology

Study Study design Sample size Follow-up Stress-exposure measure Control for confounding Results
Kuper and colleagues [15] Prospective cohort 36,332 ~13 years Work-related stressors Yes Association found for low job control and high job demands (HR = 1.3 (1.0 to 1.7) for both), and job strain (HR = 1.4 (1.1 to 1.9))
Nielsen and colleagues [16] Prospective cohort 18,932 10 years Work-related stressors Yes No association found for high work pressure, influence on job organization, and long working hours; association but no dose-response effect found for high work tempo (HR 1.25 (1.02 to 1.54))
Schernhammer and colleagues [17] Prospective cohort 37,562 8 years Work-related stressors Yes No association found for women in passive (RR = 0.90 (0.76 to 1.06)), active (RR = 0.83 (0.69 to 0.99)) or high-strain jobs (RR = 0.87 (0.73 to 1.04))
Kroenke and colleagues [18] Prospective cohort 32,826 8 years Caregiving stress Yes No association found for adult care (RR = 1.19 (0.87 to 1.62)) or child care (RR = 0.87 (0.66 to 1.16))
Nielsen and colleagues [19] Prospectivecohort 7,018 16 to 18 years Total stress at baseline Yes Lower risk associated with high stress at baseline (HR = 0.60 (0.37 to 0.97))
Surtees and colleagues [20] Prospective cohort 11,467 Median 9 years Difficulties in childhood, self-perceived stress Yes No association found for difficulties in childhood (HR = 1.02 (0.91 to 1.16)), life events within 5 years previous to study (HR = 0.99 (0.89 to 1.11)), or perceived stress within 10 years previous to study (HR = 1.17 (0.84 to 1.64))
Metcalfe and colleagues [21] Prospective cohort 991 30 years Daily stress Yes Mild correlation for moderate (HR = 2.16 (1.00 to 4.71)) and high (HR = 1.92 (0.81 to 4.55)) daily stress
Helgesson and colleagues [11] Prospective cohort 1,462 24 years Self-perceived stress Yes Association found for self-reported stress during the 5 years prior to baseline (RR = 2.1 (1.2 to 3.7))
Lillberg and colleagues [22] Prospective cohort 10,808 14 years Life events Yes Associations found for major life events (HR = 1.35 4.07)), death of a husband (HR = 2.00 (1.03 to 3.88)), or death of a close relative or friend (HR = 1.36 (1.00 to 1.86))
Lambe and colleagues [23] Registry study 27,571 cases, 141,798 controls   Loss of a child Yes Association found for loss of a child between the ages of 1 and 4 (OR = 2.65 (1.06 to 6.60))
Ollonen and colleagues [24] Limited prospective 34 cases, 81 controls (53 with benign breast disease, 28 no disease)   Life events Yes Association found for very severe and severe losses (P = 0.02) and greater number of moderate or severe losses (P = 0.0009)
Michael and colleagues [10] Prospective cohort 84,334 ~ 8 years Life events Yes Association found for one life event (HR = 1.12 (1.0 to 1.25)), no dose-response
Eskelinen and Ollonen [28] Limited prospective 34 cases, 81 controls (53 with benign breast disease, 28 no disease)   Losses and deficit in childhood Yes Association found for deficit in childhood (P <0.05) or Severe deficit in childhood (P = 0.02)
Jacobs and Bovasso [29] Prospective cohort 1,213 ~ 15 years Life events Yes Association found for maternal death in childhood (OR = 2.56 (1.59 to 4.35))
Keinan-Boker and colleagues [30] Registry study 37,872 women 2,670,238 person-years for women Holocaust exposure No Association found for Holocaust exposure (RR = 2.44 (1.46 to 4.06) for youngest birth cohort; lower but significant association for other birth cohorts)
Koupil and colleagues [31] Prospective cohort 1,429 women Not estimated Leningrad siege exposure Some Association found for Leningrad siege exposure and breast cancer mortality in women 10 to 18 years old at time of exposure (HR = 9.9 (1.1 to 86.5))
  1. Results data presented as value (95% confidence interval). HR, hazard ratio; OR, odds ratio; RR, relative risk.