Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Shalvata Mental Health Center, Hod Hasharon, Israel.
J Trauma Stress. 2018 Dec;31(6):919-926. doi: 10.1002/jts.22345. Epub 2018 Dec 6.
Data regarding cancer risk for individuals who were exposed to traumatic and stressful life events are conflicting. We sought to evaluate the association between posttraumatic stress disorder (PTSD) and the risk of the four most common solid tumors: lung, breast, prostate, and colorectal cancers. We conducted four nested case-control studies using a large UK population-based database. Cases were defined as individuals with any medical code for the specific malignancy. For every case, we used incidence-density sampling to match four controls by age, sex, practice site, and both duration and calendar time of follow-up. Exposure of interest was any diagnosis of PTSD prior to cancer diagnosis. The odds ratios (ORs) and 95% confidence intervals (CIs) for cancer risk associated with PTSD were estimated using multivariable conditional logistic regression and were adjusted for smoking status, obesity, and antidepressant use. The study population included four case groups according to cancer type. There were 19,143 cases with lung cancer (74,473 matched controls), 22,163 cases with colorectal cancer (86,538 matched controls), 31,352 cases with breast cancer (123,285 matched controls), and 27,212 cases with prostate cancer (105,940 matched controls). There was no statistically significant association between PTSD and cancer risk among any of the cancer types: lung, OR = 0.73, 95% CI [0.43, 1.23]; breast, OR = 0.73, 95% CI [0.52, 1.01]; prostate, OR = 1.24, 95% CI [0.87, 1.77]; and colorectal, OR = 1.05, 95% CI [0.68, 1.62]. Our findings indicated that participants in our study with PTSD were not at increased risk of lung, breast, prostate, and colorectal cancers.
关于经历创伤性和压力性生活事件的个体的癌症风险数据存在冲突。我们旨在评估创伤后应激障碍（PTSD）与四种最常见的实体瘤（肺癌、乳腺癌、前列腺癌和结直肠癌）风险之间的关联。我们使用一个大型英国人群数据库进行了四项嵌套病例对照研究。病例定义为有特定恶性肿瘤的任何医疗代码的个体。对于每个病例，我们使用发病率密度抽样按年龄、性别、实践地点以及癌症诊断前后的随访时间和日历时间匹配四个对照。感兴趣的暴露是癌症诊断前任何 PTSD 的诊断。使用多变量条件逻辑回归估计与 PTSD 相关的癌症风险的优势比（OR）和 95%置信区间（CI），并调整了吸烟状况、肥胖和抗抑郁药的使用情况。研究人群根据癌症类型分为四个病例组。肺癌有 19143 例（74473 例匹配对照）、结直肠癌有 22163 例（86538 例匹配对照）、乳腺癌有 31352 例（123285 例匹配对照）和前列腺癌有 27212 例（105940 例匹配对照）。在任何癌症类型中，PTSD 与癌症风险之间均无统计学显著关联：肺癌，OR=0.73，95%CI[0.43,1.23]；乳腺癌，OR=0.73，95%CI[0.52,1.01]；前列腺癌，OR=1.24，95%CI[0.87,1.77]；结直肠癌，OR=1.05，95%CI[0.68,1.62]。我们的研究结果表明，研究中的 PTSD 参与者患肺癌、乳腺癌、前列腺癌和结直肠癌的风险没有增加。
