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Table 2 Association between individual-level psychosocial stress factors and risk of breast cancer by ER status and for triple negative breast cancer

From: Neighborhood disadvantage and individual-level life stressors in relation to breast cancer incidence in US Black women

Exposure

ER+

ER−

Triple negative

Cases

Age-adjusted HR (95% CI)a

MV-adjusted HR (95% CI)b

Cases

Age-adjusted HR (95% CI)a

MV-adjusted HR (95% CI)b

Cases

Age-adjusted HR (95% CI)a

MV-adjusted HR (95% CI)b

Early-life stressors

Loss of a parent/guardian before age 18

 No

554

1.00 (ref)

1.00 (ref)

251

1.00 (ref)

1.00 (ref)

128

1.00 (ref)

1.00 (ref)

 Death of mother

69

1.14 (0.89–1.47)

1.19 (0.92–1.53)

28

1.08 (0.73–1.59)

1.09 (0.73–1.61)

17

1.29 (0.78–2.15)

1.29 (0.77–2.14)

 Death of father/guardian

102

0.85 (0.69–1.05)

0.87 (0.71–1.08)

45

0.84 (0.61–1.15)

0.84 (0.61–1.16)

26

0.94 (0.62–1.44)

0.95 (0.62–1.45)

Member of household served time in prison before age 18

 No

732

1.00 (ref)

1.00 (ref)

318

1.00 (ref)

1.00 (ref)

164

1.00 (ref)

1.00 (ref)

 Yes

39

0.75 (0.54–1.03)

0.78 (0.57–1.08)

27

1.07 (0.73–1.55)

1.18 (0.79–1.75)

14

1.16 (0.67–2.01)

1.16 (0.67–2.01)

Childhood financial hardship

 None

585

1.00 (ref)

1.00 (ref)

261

1.00 (ref)

1.00 (ref)

138

1.00 (ref)

1.00 (ref)

 Moderate

176

0.98 (0.83–1.16)

1.02 (0.86–1.20)

80

0.97 (0.76–1.25)

0.98 (0.76–1.26)

36

0.82 (0.57–1.19)

0.83 (0.57–1.20)

 Severe

73

0.79 (0.62–1.01)

0.84 (0.66–1.08)

37

0.87 (0.61–1.23)

0.87 (0.61–1.23)

24

1.07 (0.69–1.65)

1.10 (0.71–1.71)

Childhood sexual abuse

 No abuse

426

1.00 (ref)

1.00 (ref)

223

1.00 (ref)

1.00 (ref)

113

1.00 (ref)

1.00 (ref)

 Exposed to genitals of an adult

56

1.06 (0.80–1.40)

1.04 (0.79–1.38)

33

1.16 (0.80–1.68)

1.12 (0.78–1.62)

23

1.60 (1.02–2.50)

1.56 (0.99–2.45)

 Sexual assault 1–3 times

83

0.90 (0.71–1.14)

0.91 (0.72–1.15)

46

0.91 (0.66–1.26)

0.89 (0.65–1.22)

25

0.99 (0.64–1.53)

0.96 (0.62–1.49)

 Sexual assault ≥ 4 times

55

1.29 (0.97–1.71)

1.35 (1.01–1.79)

19

0.80 (0.50–1.28)

0.77 (0.48–1.24)

11

0.93 (0.50–1.73)

0.90 (0.48–1.67)

 Physical abuse only

239

1.13 (0.96–1.32)

1.12 (0.95–1.31)

120

1.05 (0.84–1.31)

1.04 (0.83–1.30)

64

1.12 (0.82–1.52)

1.11 (0.81–1.51)

Adolescent sexual abuse

 No abuse

514

1.00 (ref)

1.00 (ref)

273

1.00 (ref)

1.00 (ref)

140

1.00 (ref)

1.00 (ref)

 Exposed to genitals of an adult

63

1.07 (0.83–1.40)

1.06 (0.82–1.38)

26

0.81 (0.54–1.22)

0.80 (0.53–1.20)

12

0.73 (0.41–1.33)

0.72 (0.40–1.29)

 Sexual assault 1–3 times

130

1.07 (0.88–1.30)

1.11 (0.91–1.35)

70

1.02 (0.78–1.32)

0.99 (0.75–1.29)

41

1.16 (0.82–1.65)

1.13 (0.79–1.61)

 Sexual assault ≥ 4 times

31

1.08 (0.75–1.55)

1.16 (0.80–1.67)

13

0.81 (0.46–1.42)

0.80 (0.46–1.40)

10

1.23 (0.65–2.35)

1.23 (0.64–2.34)

 Physical abuse only

121

1.06 (0.87–1.29)

1.08 (0.89–1.32)

59

0.93 (0.70–1.24)

0.93 (0.70–1.23)

33

1.02 (0.70–1.49)

1.02 (0.70–1.50)

Adult-life stressors

Marital status

 Single

216

1.00 (ref)

1.00 (ref)

132

1.00 (ref)

1.00 (ref)

58

1.00 (ref)

1.00 (ref)

 Married/live together

605

1.25 (1.07–1.47)

1.29 (1.08–1.53)

317

1.17 (0.95–1.45)

0.96 (0.77–1.21)

139

0.88 (0.64–1.21)

1.08 (0.77–1.53)

 Separated/divorced

340

1.07 (0.89–1.28)

1.12 (0.93–1.36)

192

1.11 (0.88–1.40)

0.94 (0.73–1.20)

95

1.05 (0.81–1.36)

1.06 (0.81–1.38)

 Widowed

94

1.11 (0.86–1.45)

1.21 (0.92–1.58)

45

1.15 (0.80–1.67)

0.99 (0.68–1.45)

18

0.85 (0.51–1.43)

0.89 (0.53–1.49)

Years of education

 ≤ 12 years

194

1.00 (ref)

1.00 (ref)

121

1.00 (ref)

1.00 (ref)

58

1.00 (ref)

1.00 (ref)

 13–15 years

355

1.17 (0.98–1.40)

1.10 (0.92–1.32)

213

1.07 (0.85–1.34)

1.03 (0.82–1.29)

96

0.98 (0.71–1.36)

0.92 (0.66–1.28)

 ≥ 16 years

707

1.39 (1.19–1.64)

1.18 (1.00–1.41)

353

1.09 (0.88–1.34)

1.04 (0.83–1.31)

156

0.94 (0.69–1.27)

0.89 (0.64–1.24)

Daily racism

 Quartile 1

206

1.00 (ref)

1.00 (ref)

112

1.00 (ref)

1.00 (ref)

60

1.00 (ref)

1.00 (ref)

 Quartile 2

321

1.12 (0.94–1.33)

1.10 (0.92–1.31)

171

1.04 (0.82–1.33)

1.02 (0.81–1.30)

88

1.00 (0.72–1.39)

0.99 (0.71–1.38)

 Quartile 3

285

1.06 (0.88–1.27)

1.04 (0.87–1.25)

147

0.94 (0.73–1.20)

0.93 (0.72–1.19)

80

0.94 (0.67–1.32)

0.94 (0.67–1.32)

 Quartile 4

247

1.13 (0.94–1.37)

1.14 (0.94–1.38)

110

0.85 (0.65–1.11)

0.85 (0.65–1.11)

55

0.79 (0.54–1.14)

0.78 (0.54–1.14)

Institutional racism

 No to all

302

1.00 (ref)

1.00 (ref)

162

1.00 (ref)

1.00 (ref)

86

1.00 (ref)

1.00 (ref)

 Yes to 1

331

1.00 (0.85–1.17)

0.98 (0.84–1.14)

176

0.98 (0.79–1.21)

0.96 (0.78–1.19)

95

1.00 (0.74–1.33)

0.98 (0.73–1.32)

 Yes to 2

267

1.01 (0.86–1.19)

0.99 (0.84–1.17)

120

0.84 (0.66–1.06)

0.82 (0.65–1.05)

62

0.82 (0.59–1.13)

0.80 (0.58–1.11)

 Yes to 3

132

1.08 (0.88–1.33)

1.07 (0.87–1.31)

62

0.93 (0.70–1.25)

0.94 (0.70–1.26)

30

0.84 (0.56–1.28)

0.83 (0.55–1.26)

CESD Scale

 Score 0–15

678

1.00 (ref)

1.00 (ref)

324

1.00 (ref)

1.00 (ref)

184

1.00 (ref)

1.00 (ref)

 Score 16–22

124

1.01 (0.83–1.22)

1.02 (0.84–1.24)

60

0.98 (0.74–1.29)

0.99 (0.75–1.31)

34

0.98 (0.68–1.42)

0.99 (0.69–1.43)

 Score ≥ 23

87

0.80 (0.64–1.00)

0.84 (0.67–1.05)

45

0.83 (0.61–1.13)

0.85 (0.62–1.17)

25

0.82 (0.54–1.24)

0.83 (0.54–1.27)

Perceived stress Scale

 Score 0–4 low perceived stress

277

1.00 (ref)

1.00 (ref)

135

1.00 (ref)

1.00 (ref)

116

1.00 (ref)

1.00 (ref)

 Score 5–8, average perceived stress

214

1.02 (0.86–1.23)

1.05 (0.87–1.25)

101

0.99 (0.76–1.28)

1.01 (0.78–1.31)

101

1.18 (0.90–1.54)

1.19 (0.91–1.56)

 Score ≥ 9, high perceived stress

51

0.75 (0.55–1.01)

0.77 (0.57–1.05)

22

0.65 (0.41–1.03)

0.65 (0.41–1.03)

20

0.73 (0.46–1.18)

0.72 (0.45–1.17)

  1. ER estrogen receptor, HR hazard ratio, CI confidence interval, MV multivariable, SES socioeconomic status
  2. aHazard ratios adjusted for age and time period
  3. bHazard Ratios additionally adjusted for age at menarche, BMI at age 18, parity, age at first birth, breastfeeding, menopausal status, age at menopause, oral contraceptive use for 5 + years, family history of breast cancer, geographic region and physical activity