Department of Bioethics and Humanities, University of Washington, Seattle, WA 98195, USA.
Office of the President, California Breast Cancer Research Program, University of California, Oakland, CA 94607, USA.
Int J Environ Res Public Health. 2021 Feb 15;18(4):1871. doi: 10.3390/ijerph18041871.
Stress is a common belief among breast cancer patients and the public to explain variation in breast cancer incidence. Epidemiological studies interrogating the relationship between stress and cancer have reported mixed results. The impact of the topic and the lack of consensus has sparked this review of the literature to investigate gaps in knowledge and identify areas of research. We first present a brief summary of the biopsychosocial model generally used to conduct research on stress. We then divide the overview of the literature into areas of research focus. These include the role of distressing life events in breast cancer incidence, the role of adverse childhood events in later breast cancer incidence, the importance of race and socioeconomic status (SES) as social determinants of breast cancer incidence, and the specific role of chronic stress in relation to breast cancer. For each topic, we discuss the potential of stress as a risk factor and possible intervention strategies that could reduce the effects of stress. We then identify further research questions to be probed to fill the gaps in knowledge. We conclude with a discussion of future research directions for stress research as it relates to breast cancer incidence.
压力是乳腺癌患者和公众普遍用来解释乳腺癌发病率差异的一种常见信念。研究压力与癌症之间关系的流行病学研究报告结果不一。这一主题的影响以及缺乏共识引发了对文献的综述，以调查知识空白并确定研究领域。我们首先简要总结了通常用于研究压力的生物心理社会模型。然后，我们将文献综述分为研究重点领域。这些领域包括痛苦生活事件在乳腺癌发病率中的作用、不良童年经历在以后乳腺癌发病率中的作用、种族和社会经济地位（SES）作为乳腺癌发病率的社会决定因素的重要性、以及慢性压力与乳腺癌的关系。对于每个主题，我们讨论了压力作为风险因素的可能性，以及可能减轻压力影响的干预策略。然后，我们确定了进一步需要探究的研究问题，以填补知识空白。最后，我们讨论了与乳腺癌发病率相关的压力研究的未来研究方向。
