The association between stressful life events and breast cancer risk: A meta-analysis
The association between stressful life events and breast cancer risk: A meta-analysis
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DOI：
10.1002/ijc.11504
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发表时间：
2003-12-20
影响因子：
6.4
通讯作者：
Van der Borne, B
中科院分区：
文献类型：
--
作者：
Duijts, SFA;Zeegers, MPA;Van der Borne, B
乳腺癌是西方社会女性中最常见的癌症。研究压力性生活事件和乳腺癌风险之间的关系产生了相互矛盾的结果。本荟萃分析的目的是识别1966年至2002年12月之间关于这种关系的研究，总结和量化这种关联，并解释以前结果的不一致性。使用随机效应荟萃回归分析计算以下类别的总体优势比和标准误：压力性生活事件、配偶死亡、亲戚或朋友死亡、个人健康困难、非个人健康困难、婚姻状况变化、经济状况变化和环境状况变化。研究了是否存在发表偏倚，并进行了敏感性分析，以确定异质性，计算异质性导致的变异百分比，进行荟萃回归分析和分层。只有应激性生活事件（OR = 1.77，95% CI 1.31-2.40）、配偶死亡（OR= 1.37，95% CI 1.10-1.71）和亲友死亡（OR = 1.35，95% CI 1.09-1.68）对抑郁症的发生有统计学意义。在压力性生活事件（p = 0.00）和亲戚或朋友死亡（p = 0.02）中发现了发表偏倚。敏感性分析导致在所有类别的异质性，除了配偶的死亡。这项荟萃分析的结果不支持压力性生活事件与乳腺癌风险之间的整体关联。在配偶死亡和乳腺癌风险之间只能确定一个适度的关联。(C)2003年威利-利斯。Inc.
Breast cancer is the most prevalent cancer in women in Western societies. Studies examining the relationship between stressful life events and breast cancer risk have produced conflicting results. The purpose of this meta-analysis was to identify studies on this relationship, between 1966 and December 2002, to summarize and quantify the association and to explain the inconsistency in previous results. Summary odds ratios and standard errors were calculated, using random effect meta-regression analyses, for the following categories: stressful life events, death of spouse, death of relative or friend, personal health difficulties, nonpersonal health difficulties, change in marital status, change in financial status and change in environmental status. The presence of publication bias has been explored, and sensitivity analyses were performed to identify heterogeneity, using calculation of the percentage of variability due to heterogeneity, meta-regression analyses and stratification. Only the categories stressful life events (OR = 1.77, 95% CI 1.31-2.40), death of spouse(OR= 1.37, 95% CI 1.10-1.71) and death of relative or friend (OR = 1.35, 95% CI 1.09-1.68) showed a statistically significant effect. Publication bias was identified in both stressful life events (p = 0.00) and death of relative or friend (p = 0.02). Sensitivity analyses resulted in the identification of heterogeneity in all categories, except death of spouse. The results of this meta-analysis do not support an overall association between stressful life events and breast cancer risk. Only a modest association could be identified between death of spouse and breast cancer risk. (C) 2003 Wiley-Liss. Inc.