Review Article

Psychological Stress and Cellular Aging in Cancer: A Meta-Analysis

Table 2

Characteristics of the most relevant epidemiological studies on psychosocial factors and risk for cancer other than breast cancer.

First author/reference/locationStudy design/sampleFollow-up yearsSpecific cancer site/type of measurementEffect size (95% CI)Control for confounding

Cabaniols et al. 2011 [34] FranceCase-control study (122 cases, 122 controls)January–December 2005BrainAge, sex
Major life events (1.13-3.20)
Daily stress (0.49-1.71)
Work (0.27-1.74)

Huang et al. 2013 [35] SwedenNested case-control study (16,522 cases, 82,107 controls)1991-2009Pancreatic cancer
Psychological stress induced by
Age, sex, education, socioeconomic status region of residence, total number of children
the death of a child (1.12-1.45)
or loss of a child due to suicide (1.03-1.146)
Persons with a history of psychiatric illness after child loss (1.17-1.76)

Vasunilashorn et al. 2013 [36] TaiwanProspective cohort study (9,302 adults)1999-2010All diseases
Self-reported perceived stress (health, financial situation, occupation, relation with family members, marriage)
Mortality risk
(1.13-1.26)
Age, education, marital status, survey wave, tobacco smoking, alcohol intake, sex, mobility limitations

Momen et al. 2013 [37] Denmark and SwedenNationwide follow-up cohort study (2,729,308 children born in Denmark 1968-2007; 3,395,166 born between 1973 and 2006 in Sweden) 1,505,938 children experienced bereavement, and 9,823 were diagnosed with cancer before the age of 15 yearsStarted from birth and ended at date of cancer diagnosis, death, emigration, day before 15th birthday or at 2007 in Denmark, and 2006 in SwedenAll childhood cancers (1.04-1.17)Country, maternal characteristic at birth whether child was a twin
Central nervous system cancer (1.02-1.28)
Leukemia (1.00-1.26)

Azizi & Esmaeili 2015 [38] IranCase-control study (207 cases, 207 controls)April 2013–March 2014Colorectal cancer
Death of dears/child, parents, spouse, and first-degree families
(1.41-5.13)Age, sex, family history of colorectal cancer, history of diabetes, smoking, BMI, physical activity

Kikuchi et al. 2017 [39] JapanProspective cohort study 61,563 participants (25,018 men; 36,545 women) 330 rectal cancer cases, 680 colon cancer casesMaximum 21 years (mean 13 years)Rectal cancer
Daily life stress
Moderate level:
Age, BMI, family history of colorectal cancer, smoking habit, alcohol drinking, sleep duration/night, frequency of green leafy vegetables intake, daily time walking, bowel movement frequency, age of graduation, marital status, employment status, the number of children
men
women
(1.23-3.78)
(1.46-7.03)
High/severe level:
men
women
(1.14-2.69)
(1.01-3.31)
Colon cancer
No statistically significant association

Blanc-Lapierre et al. 2017 [40] CanadaPopulation-based case-control study (3,103 cases, 512 controls)1979-1985Different types of cancer, workplace PSAge, ethnicity education, family income, respondent status, site specific, nonoccupational and occupational covariates like smoking, occupational exposure to asbestos and silica, BMI, exposure to aromatic amines, smoking, alcohol intake
Lung (1.01-1.75)
Colon (1.15-1.98)
Bladder (1.03-1.81)
Rectal (1.10-2.10)
Stomach (1.08-2.15)

Kim et al. 2017 [41]
Korea
229 cancer patients among them 77 with PDNovember 2009–March 2011Gastric
Psychological distress
Disease stages I-III, 5-year DFS rate 60% vs 76%
Disease stage IV
Median OS 12.2 vs 13.8 months. DFS and OS were estimated compared with patients without PD
(1.07-5.68)
Age, gender, Eastern Cooperative Oncology Group performance status (0-3; 4), marriage, education, employment, and adjuvant chemotherapy

Chang et al. 2015 [42] KoreaProspective study 601,775 people (502,297 men, 99,478 women) with depression
Cases:
Men 49,744; women 7,860
20 yearsProstate cancer
Minor depression
(1.05-1.23)Age, smoking, alcohol intake, exercise, BMI, cholesterol, blood sugar, hypertension, cancer family history
Cervical cancer
Major depression (women) (0.83-0.98)
Overall cancer
Major depression:
 men
 women
(1.01-1.09)
(0.83-0.98)

O’Neil et al. 2014 [43] International19 World Mental Health surveys with DSM-IV (), 1,499 cases10Overall self-reported cancer diagnosis DSM-IVAge, gender, person-year, country, alcohol consumption, country
One disorder (1.1-1.6)
Three disorders (1.2-2.2)
> Five disorders (1.6-3.3)

Archer et al. 2015 [44] UKProspective cohort study (), 776 cases17.4Overall cancers
Chronic depressive symptoms
(0.71-1.49)Age, gender, employment grade, smoking, alcohol intake, meat consumption, physical activity, BMI, systolic blood pressure, respiratory illness, longstanding illness
285 cases<9New depressive symptoms (1.23-2.90)

Li et al. 2014 [45] ChinaCase-control study (250 cases, 500 controls)January 2007–July 2013Prostate cancerSmoking, alcohol intake, physical activity, marital status, red meat consumption, tea consumption, urinary system diseases, family history of BC, vegetables consumption
Occupational setback (1.00-2.59)
Marital separation (1.29-1.91)
Self-contained suffering (1.58-3.55)
High sensitivity to the personal comments (1.18-2.54)

Song et al. 2017 [46] JapanProspective study 101,708 participants declaring perceived stress at baseline, 17,161 cancer cases5 years and 10 yearsOverall cancer
Perceived stress at baseline
No association between baseline PS level and cancer risk. Slightly (4-6%) elevated HR in the group declaring higher PS levels vs. low-stress group. For long-term PS (79,301 participants, 963 cancer cases) with always a high PS level: (1.01-1.22) in all group and (1.05-1.34) in a subgroup of men vs. subjects declaring always a low level of PS.BMI smoking status, alcohol consumption, fruit/vegetable intake, physical activity, living arrangement, occupation, family history of cancer, study area.

Blank-Lapierre et al. 2017 [47] CanadaHospital based case-control study (1,933 cases, 1,994 controls)2005-2009Prostate cancer
Men aged <75 years at diagnosis
Age, ancestry, first-degree family history of PCa, family income, education. Marital status, BMI, type 2 diabetes, depression treated with medication, alcohol intake, smoking, physical activity at work, frequency of fruit, and vegetable consumption
Exposure to job stress (1.07-1.82)
Low-grade PCa cases
Exposure to job years
(1.02-1.08)
High-grade PCa cases
Exposure to job years
(1.03-2.29)
Perceived workplace stress duration linkage with a higher PCa risk (1.04-1.20) per 10-year increase

Vesterlund et al. 2017 [48] DenmarkDanish Nurse Cohort, 6571 participants (854 cases)January 2000–December 2013Job strain high vs lowAge, night shifts and full-work time, smoking, alcohol, BMI, physical activity at work and leisure time
Overall cancer (0.7-1.1)
Hormone-related cancer (0.6-1.2)
Virus immune-related cancer (0.5-2.5)
Digestive cancer (0.3-1.3)
Lung cancer (0.5-2.1)

Jafri et al. 2019 [49] USAMatched case-control study (102 cases, 199 controls)May 2015–December 2016Lung
Stressful life events, past 5 years
(1.11-4.37)Smoking, family history of lung cancer

Abbreviations: HR: hazard ratio; OR: odds ratio; RR: relative risk; DFS: disease-free survival; PD: psychological distress; OS: overall survival; PCa: prostate cancer; RR: relative risk; CI: confidence interval; BMI: body mass index; DSM-IV: Diagnostic and Statistical Manual of Mental Disorders.