Department of Epidemiology, University of California, Irvine, School of Medicine, Irvine, CA.
Department of Epidemiology, University of California, Irvine, School of Medicine, Irvine, CA.
Clin Breast Cancer. 2018 Aug;18(4):e521-e528. doi: 10.1016/j.clbc.2017.10.017. Epub 2017 Nov 1.
The influence of stress on breast cancer risk remains unknown. The goal of the present study was to determine the effect of stress in the form of salient positive and negative valence life events (LEs) on primary invasive breast cancer risk. We hypothesized that salient negative LEs would increase breast cancer risk and salient positive LEs would attenuate this increased risk.
We used a case-control design with 664 cases identified through the Cancer Surveillance Program of Orange County and 203 population-based controls. Participants completed a risk factor questionnaire, which included a LE section. Fourteen salient LEs of positive or negative valence were used to quantify stress exposure. A baseline model was constructed, and odds ratios (ORs) were calculated using multivariate unconditional logistic regression.
Negative LEs were associated with increased breast cancer risk. The OR for ≥ 4 negative LEs showed a 2.81-fold increase in breast cancer risk (OR, 2.81; 95% confidence interval [CI], 1.47-5.36). A significant dose-response relationship between lifetime negative valence LEs and breast cancer risk was found. Previous personal illness increased breast cancer risk by 3.6-fold (OR, 3.60; 95% CI, 2.50-5.20). In contrast, abortion was associated with a 45% decrease in breast cancer risk (OR, 0.55; 95% CI, 0.34-0.89). Salient positive LEs did not have a significant effect on breast cancer risk. However, they seemed to buffer the adverse effect of salient negative LEs on breast cancer risk.
The findings from the present study support the role of salient negative LEs in promoting breast cancer development, with a possible buffering effect of salient positive LEs.
压力对乳腺癌风险的影响尚不清楚。本研究的目的是确定以显著正、负效价生活事件(LE)形式出现的压力对原发性浸润性乳腺癌风险的影响。我们假设显著负性 LE 会增加乳腺癌风险,而显著正性 LE 会减弱这种风险增加。
我们采用病例对照设计,通过橙县癌症监测计划(Cancer Surveillance Program of Orange County)确定了 664 例病例和 203 例基于人群的对照。参与者完成了一份危险因素问卷,其中包括一个 LE 部分。使用 14 个正、负效价的显著 LE 来量化应激暴露。构建了一个基线模型,并使用多变量非条件逻辑回归计算了比值比(ORs)。
负性 LE 与乳腺癌风险增加相关。发生≥4 个负性 LE 的 OR 显示乳腺癌风险增加 2.81 倍(OR,2.81;95%置信区间[CI],1.47-5.36)。发现一生中负效价 LE 与乳腺癌风险之间存在显著的剂量-反应关系。既往个人疾病使乳腺癌风险增加 3.6 倍(OR,3.60;95%CI,2.50-5.20)。相反,流产与乳腺癌风险降低 45%相关(OR,0.55;95%CI,0.34-0.89)。显著正性 LE 对乳腺癌风险无显著影响。然而,它们似乎缓冲了显著负性 LE 对乳腺癌风险的不利影响。
本研究结果支持显著负性 LE 在促进乳腺癌发展中的作用,显著正性 LE 可能具有缓冲作用。