Self-reported stress levels predict subsequent breast cancer in a cohort of Swedish women

Helgesson, Östen; Cabrera, Claudia; Lapidus, Leif; Bengtsson, Calle; Lissner, Lauren

doi:10.1097/00008469-200310000-00006

Cited by 67 publications

(62 citation statements)

References 15 publications

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“…Six studies calculated relative risk for breast cancer without considering categories, but rather self-rated intensity or frequency of stressful events, regardless of the situation that caused it 8,9,14,15,16,17 . We chose the RR related to the highest intensity in each article, ignoring the RR related to stressful events rated as less intense or less frequent.…”

Section: Discussionmentioning

confidence: 99%

“…Helgesson et al 8 classified the stressful event dichotomously, as whether or not it had produced intense stress (yes or no). We considered the result for women that answered yes.…”

Section: Discussionmentioning

confidence: 99%

“…Items 9 and 26 were not used in the evaluation of case-control studies since they contain questions that do not apply to this type of study. Items 4,8,13,14,15,19,23, and 24 were not scored because they pertain to intervention studies, since no publication included in this review was of the experimental type.…”

Section: Methodological Qualitymentioning

confidence: 99%

“…A positive association between stress and breast cancer was observed in cohort studies 8,9 and some case-control studies 9,10,11,12,13,14,15 , while other case-control studies do not indicate evidence of such an association 16,17 .…”

Section: Introductionmentioning

confidence: 92%

“…A prospective cohort study concluded that stressful life events in women are associated with increased incidence of breast cancer 8 . There is a biological plausibility to this correlation, since high estrogen concentration is characterized as a risk factor for breast cancer, that is, inhibition of estrogen synthesis induced by chronic stress could explain the increased incidence of breast cancer in women exposed to high degrees of stress.…”

Section: Introductionmentioning

confidence: 99%

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Association between stress and breast cancer in women: a meta-analysis

et al. 2009

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The objective of the current meta-analysis was to verify the association between stressful life events and primary breast cancer incidence in women. A total of 618 studies from 1982-2007 were found in the PubMed, LILACS, and Cochrane Library databases. Methodological quality was evaluated according to the Downs & Black criteria. Eight studies were selected (six case-controls and two cohorts). The studies were grouped in three analyses, two of which based on the categories widowhood and divorce and the other based on self-rated intensity and frequency of stressful events. Relative risks were: widowhood 1.04 (95%CI: 0.75-1.44; p = 0.800); divorce 1.03 (95%: 0.72-1.48; p = 0.850); and intensity/frequency of stress 1.73 (95%CI: 0.98-3.05; p = 0.059). We conclude that stressful life events as a whole are not associated with risk of breast cancer in women. However, it is not possible to rule out high-intensity stress as a risk factor for breast cancer.

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Section: Discussionmentioning

confidence: 99%

“…Helgesson et al 8 classified the stressful event dichotomously, as whether or not it had produced intense stress (yes or no). We considered the result for women that answered yes.…”

Section: Discussionmentioning

confidence: 99%

Section: Methodological Qualitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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Association between stress and breast cancer in women: a meta-analysis

et al. 2009

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Hydrocortisone down‐regulates the tumor suppressor gene BRCA1 in mammary cells: A possible molecular link between stress and breast cancer

Antonova

Mueller

2008

Genes Chromosomes & Cancer

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Psychological stress has been correlated with breast cancer development in numerous epidemiological studies. However, physiological and molecular models which may account for this association are not readily available. We have found that the stress hormone hydrocortisone (cortisol) down-regulates the expression of the breast cancer susceptibility gene BRCA1 in the nonmalignant mouse mammary cell line EPH4. This effect is concentration-dependent, is reliant on the continuous presence of hydrocortisone, and is not affected by the addition of lactogenic hormones, or growth conditions. Hydrocortisone was also found to negate a known positive effect of estrogen on BRCA1 expression and, therefore, may interfere with estrogen-related signaling in mammary epithelial cells. The repressive effect of hydrocortisone is diminished or lost in the mouse mammary lines HC-11 and SP1, respectively, suggesting regulation of the BRCA1 may differ between lines. We have uncovered two promoter regulatory sites, which are involved in BRCA1 regulation by hydrocortisone, namely the RIBS and UP regulatory elements. Binding of the transcription factor GABP to both sites is lost upon hydrocortisone addition, though the levels of these factors are not altered by hydrocortisone treatment. Because BRCA1 activity is important for a number of intracellular pathways involved in prevention of tumorigenesis, its observed down-regulation may represent a novel molecular mechanism for cortisol's involvement in breast cancer development.

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Where does stress happen? Ecological momentary assessment of daily stressors using a mobile phone app

Yao,

Nelson,

Stavrianakis

et al. 2024

Mental Health Science

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Despite the importance of daily stress to individuals' health and wellbeing, few studies have explored where stress happens in real time, that is, dynamic stress processes in different spaces. As such, stress interventions rarely account for the environment in which stress occurs. We used mobile phone based ecological momentary assessment (EMA) to collect daily stress data. Thirty‐three participants utilized a mobile‐phone‐based EMA app to self‐report stressors as they went about their daily lives. Geographic coordinates were automatically collected with each stress report. Data from thematic analysis of stressors by location (home, work, work from home, other) were used to determine whether certain stressors were more prevalent in certain environments. Nine daily stressors significantly differed by location. Work‐related stress was reported more often at work. Pets, household chores, sleep, and media‐related stressors were reported most at home. Physical illnesses, vehicle issues, and safety/security stressors occurred most often while participants were “working from home.” Traffic‐related stress was experienced more commonly in “other” environments. Other 18 stressors were generated regardless of location, suggesting that these stressors were persistent and without respect to location. Study findings expand the understanding of environments in which specific stressors occur, providing baseline data for potential targeted “just‐in‐time” stress interventions tailored to unique stressors in specific environments. We also provide findings related to the “work from home” phenomenon. Further work is needed to better understand the unique stressors among the large number of individuals who transitioned to working from home during and after the COVID‐19 pandemic.

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Self-reported stress levels predict subsequent breast cancer in a cohort of Swedish women

Cited by 67 publications

References 15 publications

Association between stress and breast cancer in women: a meta-analysis

Association between stress and breast cancer in women: a meta-analysis

Hydrocortisone down‐regulates the tumor suppressor gene BRCA1 in mammary cells: A possible molecular link between stress and breast cancer

Where does stress happen? Ecological momentary assessment of daily stressors using a mobile phone app

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