Levav I, Kohn R, Iscovich J, Abramson J H, Tsai W Y, Vigdorovich D
Pan American Health Organization/World Health Organization, Washington, DC, USA.
Am J Public Health. 2000 Oct;90(10):1601-7. doi: 10.2105/ajph.90.10.1601.
This study investigated the effect of parental bereavement on cancer incidence and survival.
A cohort of 6284 Jewish Israelis who lost an adult son in the Yom Kippur War or in an accident between 1970 and 1977 was followed for 20 years. We compared the incidence of cancer in this cohort with that among nonbereaved members of the population by logistic regression analysis. The survival of bereaved parents with cancer was compared with that of matched controls with cancer.
Increased incidence was found for lymphatic and hematopoietic malignancies among the parents of accident victims (odds ratio [OR] = 2.01; 95% confidence interval [CI] = 1.30, 3.11) and among war-bereaved parents (OR = 1.47; 95% CI = 1.13, 1.92), as well as for melanomas (OR = 4.62 [95% CI = 1.93, 11.06] and 1.71 [95% CI = 1.06, 2.76], respectively). Accident-bereaved parents also had an increased risk of respiratory cancer (OR = 1.50; 95% CI = 1.07, 2.11). The survival study showed that the risk of death was increased by bereavement if the cancer had been diagnosed before the loss, but not after.
This study showed an effect of stress on the incidence of malignancies for selected sites and accelerated demise among parents bereaved following a diagnosis of cancer, but not among those bereaved before such a diagnosis.
本研究调查了父母丧亲之痛对癌症发病率和生存率的影响。
对1970年至1977年间在赎罪日战争或事故中失去成年儿子的6284名以色列犹太人群体进行了为期20年的随访。通过逻辑回归分析,我们将该队列中的癌症发病率与非丧亲人群的发病率进行了比较。将患癌症的丧亲父母的生存率与匹配的患癌症对照组的生存率进行了比较。
事故受害者的父母中,淋巴和造血系统恶性肿瘤的发病率增加(优势比[OR]=2.01;95%置信区间[CI]=1.30,3.11),战争丧亲父母中也是如此(OR=1.47;95%CI=1.13,1.92),黑色素瘤的发病率也增加(分别为OR=4.62[95%CI=1.93,11.06]和1.71[95%CI=1.06,2.76])。事故丧亲父母患呼吸道癌症的风险也增加(OR=1.50;95%CI=1.07,2.11)。生存研究表明,如果癌症在丧亲之前被诊断出来,丧亲会增加死亡风险,但在丧亲之后被诊断则不会。
本研究表明,压力对某些特定部位的恶性肿瘤发病率有影响,并且在癌症诊断后丧亲的父母中会加速死亡,但在癌症诊断前丧亲的父母中则不会。