Johansen C, Olsen J H
Danish Cancer Society, Division for Cancer Epidemiology, Copenhagen.
Br J Cancer. 1997;75(1):144-8. doi: 10.1038/bjc.1997.24.
Psychological stress has been claimed to contribute to the onset of cancer and to increase mortality from a number of non-malignant diseases. We investigated the effect of a genuine psychological stressor, i.e. cancer in a child, on the incidence of cancer and mortality from non-malignant diseases of 11,231 parents in a Danish nationwide population-based study. The children were identified from records in the Danish Cancer Registry for the period 1943-85; their parents were identified from population registers. Overall, 1665 parental malignancies were diagnosed from the date the cancer of the child was reported until 1992, compared with 1702 expected from national incidence rates, yielding standardized incidence ratios of 1.0 (95% confidence interval, 0.9-1.0) for all parents, 1.0 for mothers and 1.0 for fathers. No statistically significant deviation of the relative risk from unity was seen for any period of follow-up after the stressful event, and no excess risk was seen for any particular type of cancer. Moreover, a total of 2137 parental deaths were observed over the period 1974-92, compared with 2333 expected from national mortality rates, giving an overall standardized mortality ratio of 0.9 (range 0.9-1.0). No excess mortality was seen from causes associated with allergic illness, autoimmune conditions, chronic illness or changes in behaviour. Our data provide no support for the hypothesis of an association between psychological stress and the incidence of cancer or mortality from non-malignant diseases. We conclude that the human organism is highly adaptable, even to extreme psychological stress.
心理压力被认为会促使癌症的发生,并增加多种非恶性疾病的死亡率。在一项基于丹麦全国人口的研究中,我们调查了一种真实的心理压力源,即孩子患癌症,对11231名父母患癌症的发病率以及非恶性疾病死亡率的影响。通过丹麦癌症登记处1943 - 1985年期间的记录确定这些孩子;从人口登记册中确定他们的父母。总体而言,从孩子癌症被报告之日到1992年,共诊断出1665例父母患恶性肿瘤,而根据全国发病率预期为1702例,所有父母的标准化发病率为1.0(95%置信区间,0.9 - 1.0),母亲为1.0,父亲为1.0。在压力事件后的任何随访期间,相对风险与1均无统计学显著偏差,且未发现任何特定类型癌症的额外风险。此外,在1974 - 1992年期间共观察到2137例父母死亡,而根据全国死亡率预期为2333例,总体标准化死亡率为0.9(范围0.9 - 1.0)。未发现与过敏性疾病、自身免疫性疾病、慢性病或行为改变相关原因导致的额外死亡率。我们的数据不支持心理压力与癌症发病率或非恶性疾病死亡率之间存在关联的假设。我们得出结论,人类机体具有高度适应性,即使面对极端心理压力也是如此。