应激源对女性健康倡议中乳腺癌发病率的影响。
Influence of stressors on breast cancer incidence in the Women's Health Initiative.
作者信息
Michael Yvonne L, Carlson Nichole E, Chlebowski Rowan T, Aickin Mikel, Weihs Karen L, Ockene Judith K, Bowen Deborah J, Ritenbaugh Cheryl
机构信息
Department of Public Health and Preventive Medicine, Oregon Health and Science University, Portland, OR 97239-3098, USA.
出版信息
Health Psychol. 2009 Mar;28(2):137-46. doi: 10.1037/a0012982.
OBJECTIVE
To examine associations among life events stress, social support, and breast cancer incidence in a cohort of postmenopausal women. DESIGN AND MAIN OUTCOME MEASURE: Women's Health Initiative observational study participants, breast cancer free at entry, who provided assessment of stressful life events, social support, and breast cancer risk factors, were prospectively followed for breast cancer incidence (n = 84,334).
RESULTS
During an average of 7.6 years of follow-up, 2,481 invasive breast cancers were diagnosed. In age-adjusted proportional hazards models, 1 stressful life event was associated with increased risk, but risk decreased with each additional stressful life event. After adjustment for confounders the decreasing risk was not significant. Stressful life events and social support appeared to interact in relation to breast cancer risk such that women who had greater number of stressful life events and low social support had a decreased risk of breast cancer.
CONCLUSIONS
This study found no independent association between stressful life events and breast cancer risk. The results are compatible with a more complex model of psychosocial factors interacting in relation to breast cancer risk.
目的
在一群绝经后女性中研究生活事件压力、社会支持与乳腺癌发病率之间的关联。设计与主要观察指标：女性健康倡议观察性研究的参与者，入组时无乳腺癌，她们提供了应激性生活事件、社会支持和乳腺癌风险因素的评估，对其乳腺癌发病率进行前瞻性随访（n = 84,334）。
结果
在平均7.6年的随访期间，诊断出2481例浸润性乳腺癌。在年龄调整的比例风险模型中，1次应激性生活事件与风险增加相关，但每增加1次应激性生活事件风险则降低。在对混杂因素进行调整后，风险降低并不显著。应激性生活事件和社会支持在乳腺癌风险方面似乎存在相互作用，即应激性生活事件数量较多且社会支持较低的女性患乳腺癌的风险降低。
结论
本研究未发现应激性生活事件与乳腺癌风险之间存在独立关联。这些结果与心理社会因素在乳腺癌风险方面相互作用的更复杂模型相符。
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