Work stress and risk of cancer: meta-analysis of 5700 incident cancer events in 116 000 European men and women

Abstract

Objective To investigate whether work related stress, measured and defined as job strain, is associated with the overall risk of cancer and the risk of colorectal, lung, breast, or prostate cancers.Design Meta-analysis of pooled prospective individual participant data from 12 European cohort studies including 116 056 men and women aged 17-70 who were free from cancer at study baseline and were followed-up for a median of 12 years. Work stress was measured and defined as job strain, which was self reported at baseline. Incident cancers (all n=5765, colorectal cancer n=522, lung cancer n=374, breast cancer n=1010, prostate cancer n=865) were ascertained from cancer, hospital admission, and death registers. Data were analysed in each study with Cox regression and the study specific estimates pooled in meta-analyses. Models were adjusted for age, sex, socioeconomic position, body mass index (BMI), smoking, and alcohol intake Results A harmonised measure of work stress, high job strain, was not associated with overall risk of cancer (hazard ratio 0.97, 95% confidence interval 0.90 to 1.04) in the multivariable adjusted analyses. Similarly, no association was observed between job strain and the risk of colorectal (1.16, 0.90 to 1.48), lung (1.17, 0.88 to 1.54), breast (0.97, 0.82 to 1.14), or prostate (0.86, 0.68 to 1.09) cancers. There was no clear evidence for an association between the categories of job strain and the risk of cancer.Conclusions These findings suggest that work related stress, measured and defined as job strain, at baseline is unlikely to be an important risk factor for colorectal, lung, breast, or prostate cancers.

Recommendations for individual participant data meta-analyses on work stressors and health outcomes: comments on IPD-Work Consortium papers

“…The Consortium developed an approach for creating comparable job strain groups between the two questionnaires as part of the harmonization process of job strain measures across the 17 cohort data in the following way: (i) they dropped three job control items from some of their cohort data [eg, data from the Belstress (33) and GAZEL (34) studies] in which job control had been assessed with the standard nine JCQ control items in order to make the same number of items for job control as in the DCQ; (ii) they then used simple summation-based scale formulas rather than standard JCQ scale formulas for job control and job demands; and (iii) they defined high job strain based on the medians of the job control and job demands scores. This Consortium approach has been assumed by the Consortium to be free of major errors in their meta-analyses (17,18,(35)(36)(37). Our recent analysis with a dataset from a random population sample of middle-aged Malmo men and women (32), who were given a questionnaire with the 14 JCQ and 11 DCQ items for job control and demands, indicated two major weaknesses of the Consortium approach compared to using the standard JCQ scale formulas for job control and demands: a lower (5-7%) prevalence of job strain and a lower agreement percentage of job strain between the JCQ and the DCQ.…”

Physical Activity and its Relation to Cancer Risk: Updating the Evidence

“…To date, biologic mechanisms by which physical activity can influence cancer have not been established; however several mechanisms through which physical activity exerts effects have been proposed (Feig et al, 1994;Toyokuni et al, 1995;Hoffman-Goetz et al, 1998;Shephard and Shek, 1998;Rundle, 2005;Garofalo and Surmacz, 2006;Kay and Sing, 2006;Kruk and AboulEnein, 2006;2007;Szlosarek et al, 2006;Wetmore and Ulrich, 2006;Tworoger et al, 2007a;WCRF/AICR, 2007;Coyle, 2008;Renehan et al, 2008;Neilson et al, 2009;Thompson et al, 2009;Verna and Montgomery, 2009;Friedenreich et al, 2010a;Kruk, 2011;Lynch et al, 2011;Heikkila et al, 2013) and examined in randomized controlled trials (McTiernan et al, 2005;Abrahamson et al, 2007;Tworoger et al, 2007b;Hawkins et al, 2008;Balducci et al, 2010;Campbell et al, 2010;Friedenreich et al, 2010b;2010c;Reding et al, 2011).…”

Diffuse large b-cell lymphoma with hemophagocytic syndrome in an HIV+ patient treated with CCR5- bone marrow transplant

“…There was no clear evidence for an association between the categories of job strain and the risk of cancer. The study includes 116 056 men and women, aged 17-70, who were free from cancer at baseline, and have a median of 12 years follow-up [21].…”