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 | Â | 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) | Â | 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) | Â | 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)) |