Impact of major life events on breast-cancer-specific mortality: A case fatality study on 8000 breast cancer patients |
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| Institution: | 1. Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research Unioninkatu 22, 00130 Helsinki, Finland;2. University of Helsinki, Department of Public Health, PO Box 41 (Mannerheimintie 172), FI-00014 University of Helsinki, Finland;3. Faculty of Social Sciences, University of Tampere, FI-33014 University of Tampere, Finland;1. Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Denmark;2. Division of Dermatology, University of Louisville, Louisville, KY, USA;3. Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Denmark;1. CESP (Center for Research in Epidemiology and Population Health), INSERM U1018, Cancer and Environment Team, Université Paris-Saclay, Université Paris-Sud, Villejuif, France;2. Registre Général des tumeurs de Calvados, Centre François Baclesse, Caen, France;3. U1086 Inserm UCNB, Cancers and Prevention, Caen, France;4. Centre de Lutte contre le Cancer Jean Godinot, Reims, France;1. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany;2. Division of Hematology, Thomas Jefferson University, Philadelphia, PA, USA;3. German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany;4. Division of Preventive Oncology, German Cancer Research Center and National Center for Tumor Diseases, Heidelberg, Germany;1. Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan;2. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, 7th floor, Boston, MA, 02115 USA;3. Department of Urology, Kanto Rosai Hospital, 1-1 Kizukisumiyoshi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-8510, Japan;1. Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, United States;2. University of Illinois at Chicago Cancer Center, Cancer Control and Population Science Research Program, Chicago, United States;3. Institute for Health Research and Policy, Chicago, United States;4. Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago, Chicago, United States;5. School of Public Health, University of Alberta, Edmonton, Alberta, Canada;6. University of Illinois at Chicago, Department of Pediatrics, Chicago, United States;7. Survey Research Laboratory, Public Administration, University of Illinois at Chicago, 412 South Peoria Street, Chicago, 60607, United States;8. University of Illinois at Chicago, Department of Medicine, Chicago, United States;9. Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, United States;1. Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012 Paris, France;2. IRD, UMR 5569, HydroSciences, F-34394 Montpellier, France;3. Santé Publique France, French national public health agency, F-94415 Saint-Maurice, France;4. INSERM, Epidemiology and Population Health Research Centre (CESP), U1018, Gender, Sexuality and Health Team, F-94276 Le Kremlin-Bicêtre, France;5. Univ Paris-Sud, UMRS 1018, F-94276 Le Kremlin-Bicêtre, France;6. INED, F-75012 Paris, France |
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| Abstract: | BackgroundIt has been suggested that long-term activation of the body’s stress–response system and subsequent overexposure to stress hormones may be associated with increased morbidity. However, evidence on the impact of major life events on mortality from breast cancer (BC) remains inconclusive. The main aim of this study is to investigate whether major negatively or positively experienced life events before or after diagnosis have an effect on BC-specific mortality in women who have survived with BC for at least 2 years.MethodsWe conducted a case fatality study with data on life events from a self-administered survey and data on BC from the Finnish Cancer Registry. Cox models were fitted to estimate BC mortality hazard ratios (MRs) between those who have undergone major life events and those who haven’t.ResultsNone of the pre-diagnostic negative life events had any effect on BC-specific mortality. Regarding post-diagnostic events, the effect was greatest in women with moderate scores of events. As for event-specific scores, increased BC mortality was observed with spouse unemployment, relationship problems, and death of a close friend. By contrast, falling in love and positive developments in hobbies were shown to be associated with lower BC mortality (MRs 0.67, 95%CI: 0.49–0.92 and 0.74, 95%CI: 0.57–0.96, respectively). In an analysis restricted to recently diagnosed cases (2007), also death of a child and of a mother was associated with increased BC mortality.ConclusionsSome major life events regarding close personal relationships may play a role in BC-specific mortality, with certain negative life events increasing BC mortality and positive events decreasing it. The observed favorable associations between positive developments in romantic relationships and hobbies and BC mortality are likely to reflect the importance of social interaction and support. |
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| Keywords: | Life events Stress Breast cancer Oncology Mortality Epidemiology Social support |
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