Do stress-related psychosocial factors contribute to cancer incidence and survival?

Y Chida, M Hamer, J Wardle, A Steptoe - Nature clinical practice …, 2008 - nature.com
Y Chida, M Hamer, J Wardle, A Steptoe
Nature clinical practice Oncology, 2008nature.com
A substantial body of research has investigated the associations between stress-related
psychosocial factors and cancer outcomes. Previous narrative reviews have been
inconclusive. In this Review, we evaluated longitudinal associations between stress and
cancer using meta-analytic methods. The results of 165 studies indicate that stress-related
psychosocial factors are associated with higher cancer incidence in initially healthy
populations (P= 0.005); in addition, poorer survival in patients with diagnosed cancer was …
Abstract
A substantial body of research has investigated the associations between stress-related psychosocial factors and cancer outcomes. Previous narrative reviews have been inconclusive. In this Review, we evaluated longitudinal associations between stress and cancer using meta-analytic methods. The results of 165 studies indicate that stress-related psychosocial factors are associated with higher cancer incidence in initially healthy populations (P= 0.005); in addition, poorer survival in patients with diagnosed cancer was noted in 330 studies (P< 0.001), and higher cancer mortality was seen in 53 studies (P< 0.001). Subgroup meta-analyses demonstrate that stressful life experiences are related to poorer cancer survival and higher mortality but not to an increased incidence. Stress-prone personality or unfavorable coping styles and negative emotional responses or poor quality of life were related to higher cancer incidence, poorer cancer survival and higher cancer mortality. Site-specific analyses indicate that psychosocial factors are associated with a higher incidence of lung cancer and poorer survival in patients with breast, lung, head and neck, hepatobiliary, and lymphoid or hematopoietic cancers. These analyses suggest that stress-related psychosocial factors have an adverse effect on cancer incidence and survival, although there is evidence of publication bias and results should be interpreted with caution.
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