Abstract
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.
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- Ader R., Cohen N., Felten D. Psychoneuroimmunology: interactions between the nervous system and the immune system. Lancet. 1995 Jan 14;345(8942):99–103. doi: 10.1016/s0140-6736(95)90066-7. [DOI] [PubMed] [Google Scholar]
- Anderson K. O., Bradley L. A., Young L. D., McDaniel L. K., Wise C. M. Rheumatoid arthritis: review of psychological factors related to etiology, effects, and treatment. Psychol Bull. 1985 Sep;98(2):358–387. [PubMed] [Google Scholar]
- Birkeland S. A., Storm H. H., Lamm L. U., Barlow L., Blohmé I., Forsberg B., Eklund B., Fjeldborg O., Friedberg M., Frödin L. Cancer risk after renal transplantation in the Nordic countries, 1964-1986. Int J Cancer. 1995 Jan 17;60(2):183–189. doi: 10.1002/ijc.2910600209. [DOI] [PubMed] [Google Scholar]
- Bullman T. A., Kang H. K. Posttraumatic stress disorder and the risk of traumatic deaths among Vietnam veterans. J Nerv Ment Dis. 1994 Nov;182(11):604–610. doi: 10.1097/00005053-199411000-00002. [DOI] [PubMed] [Google Scholar]
- Chen C. C., David A. S., Nunnerley H., Michell M., Dawson J. L., Berry H., Dobbs J., Fahy T. Adverse life events and breast cancer: case-control study. BMJ. 1995 Dec 9;311(7019):1527–1530. doi: 10.1136/bmj.311.7019.1527. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chouinard E., Walter S. Recall bias in case-control studies: an empirical analysis and theoretical framework. J Clin Epidemiol. 1995 Feb;48(2):245–254. doi: 10.1016/0895-4356(94)00132-a. [DOI] [PubMed] [Google Scholar]
- Courtney J. G., Longnecker M. P., Theorell T., Gerhardsson de Verdier M. Stressful life events and the risk of colorectal cancer. Epidemiology. 1993 Sep;4(5):407–414. doi: 10.1097/00001648-199309000-00005. [DOI] [PubMed] [Google Scholar]
- Ewertz M. Bereavement and breast cancer. Br J Cancer. 1986 May;53(5):701–703. doi: 10.1038/bjc.1986.117. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fisher E. B., Jr, Delamater A. M., Bertelson A. D., Kirkley B. G. Psychological factors in diabetes and its treatment. J Consult Clin Psychol. 1982 Dec;50(6):993–1003. doi: 10.1037//0022-006x.50.6.993. [DOI] [PubMed] [Google Scholar]
- Forsén A. Psychosocial stress as a risk for breast cancer. Psychother Psychosom. 1991;55(2-4):176–185. doi: 10.1159/000288427. [DOI] [PubMed] [Google Scholar]
- Glaser R., Kiecolt-Glaser J. K., Speicher C. E., Holliday J. E. Stress, loneliness, and changes in herpesvirus latency. J Behav Med. 1985 Sep;8(3):249–260. doi: 10.1007/BF00870312. [DOI] [PubMed] [Google Scholar]
- Greer S., Morris T. Psychological attributes of women who develop breast cancer: a controlled study. J Psychosom Res. 1975 Apr;19(2):147–153. doi: 10.1016/0022-3999(75)90062-8. [DOI] [PubMed] [Google Scholar]
- Holmes T. H., Rahe R. H. The Social Readjustment Rating Scale. J Psychosom Res. 1967 Aug;11(2):213–218. doi: 10.1016/0022-3999(67)90010-4. [DOI] [PubMed] [Google Scholar]
- Horne R. L., Picard R. S. Psychosocial risk factors for lung cancer. Psychosom Med. 1979 Nov;41(7):503–514. doi: 10.1097/00006842-197911000-00001. [DOI] [PubMed] [Google Scholar]
- Iversen L., Andersen O., Andersen P. K., Christoffersen K., Keiding N. Unemployment and mortality in Denmark, 1970-80. Br Med J (Clin Res Ed) 1987 Oct 10;295(6603):879–884. doi: 10.1136/bmj.295.6603.879. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jacobs T. J., Charles E. Life events and the occurrence of cancer in children. Psychosom Med. 1980 Jan;42(1):11–24. doi: 10.1097/00006842-198001000-00002. [DOI] [PubMed] [Google Scholar]
- Jensen O. M., Storm H. H., Jensen H. S. Cancer registration in Denmark and the study of multiple primary cancers, 1943-80. Natl Cancer Inst Monogr. 1985 Dec;68:245–251. [PubMed] [Google Scholar]
- Jones D. R., Goldblatt P. O., Leon D. A. Bereavement and cancer: some data on deaths of spouses from the longitudinal study of Office of Population Censuses and Surveys. Br Med J (Clin Res Ed) 1984 Aug 25;289(6443):461–464. doi: 10.1136/bmj.289.6443.461. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kiecolt-Glaser J. K., Marucha P. T., Malarkey W. B., Mercado A. M., Glaser R. Slowing of wound healing by psychological stress. Lancet. 1995 Nov 4;346(8984):1194–1196. doi: 10.1016/s0140-6736(95)92899-5. [DOI] [PubMed] [Google Scholar]
- Kinlen L. J., Webster A. D., Bird A. G., Haile R., Peto J., Soothill J. F., Thompson R. A. Prospective study of cancer in patients with hypogammaglobulinaemia. Lancet. 1985 Feb 2;1(8423):263–266. doi: 10.1016/s0140-6736(85)91037-2. [DOI] [PubMed] [Google Scholar]
- Kune S., Kune G. A., Watson L. F., Rahe R. H. Recent life change and large bowel cancer. Data from the Melbourne Colorectal Cancer Study. J Clin Epidemiol. 1991;44(1):57–68. doi: 10.1016/0895-4356(91)90201-j. [DOI] [PubMed] [Google Scholar]
- Kvikstad A., Vatten L. J., Tretli S., Kvinnsland S. Death of a husband or marital divorce related to risk of breast cancer in middle-aged women. A nested case-control study among Norwegian women born 1935-1954. Eur J Cancer. 1994;30A(4):473–477. doi: 10.1016/0959-8049(94)90422-7. [DOI] [PubMed] [Google Scholar]
- Lehrer S. Life change and gastric cancer. Psychosom Med. 1980 Sep;42(5):499–502. doi: 10.1097/00006842-198009000-00004. [DOI] [PubMed] [Google Scholar]
- Moser K. A., Goldblatt P. O., Fox A. J., Jones D. R. Unemployment and mortality: comparison of the 1971 and 1981 longitudinal study census samples. Br Med J (Clin Res Ed) 1987 Jan 10;294(6564):86–90. doi: 10.1136/bmj.294.6564.86. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Olsen J. H., Boice J. D., Jr, Seersholm N., Bautz A., Fraumeni J. F., Jr Cancer in the parents of children with cancer. N Engl J Med. 1995 Dec 14;333(24):1594–1599. doi: 10.1056/NEJM199512143332403. [DOI] [PubMed] [Google Scholar]
- Olsen J. H., Winther J., Brown P. N. Risk of nonocular cancer in first-degree relatives of retinoblastoma patients. Hum Genet. 1990 Aug;85(3):283–287. doi: 10.1007/BF00206747. [DOI] [PubMed] [Google Scholar]
- Petrich J., Holmes T. H. Life change and onset of illness. Med Clin North Am. 1977 Jul;61(4):825–838. doi: 10.1016/s0025-7125(16)31300-1. [DOI] [PubMed] [Google Scholar]
- Rabkin C. S., Yellin F. Cancer incidence in a population with a high prevalence of infection with human immunodeficiency virus type 1. J Natl Cancer Inst. 1994 Nov 16;86(22):1711–1716. doi: 10.1093/jnci/86.22.1711. [DOI] [PubMed] [Google Scholar]
- Rahe R. H. Life change measurement clarification. Psychosom Med. 1978 Mar;40(2):95–98. doi: 10.1097/00006842-197803000-00001. [DOI] [PubMed] [Google Scholar]
- Rahe R. H. The more things change... Psychosom Med. 1994 Jul-Aug;56(4):306–307. doi: 10.1097/00006842-199407000-00005. [DOI] [PubMed] [Google Scholar]
- Schonfield J. Psychological and life-experience differences between Israeli women with benign and cancerous breast lesions. J Psychosom Res. 1975;19(4):229–234. doi: 10.1016/0022-3999(75)90018-5. [DOI] [PubMed] [Google Scholar]
- Temkin N. R., Davis G. R. Stress as a risk factor for seizures among adults with epilepsy. Epilepsia. 1984 Aug;25(4):450–456. doi: 10.1111/j.1528-1157.1984.tb03442.x. [DOI] [PubMed] [Google Scholar]
- Winsa B., Adami H. O., Bergström R., Gamstedt A., Dahlberg P. A., Adamson U., Jansson R., Karlsson A. Stressful life events and Graves' disease. Lancet. 1991 Dec 14;338(8781):1475–1479. doi: 10.1016/0140-6736(91)92298-g. [DOI] [PubMed] [Google Scholar]