Impact of major life events on breast-cancer-specific mortality : A case fatality study on 8000 breast cancer patients

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http://hdl.handle.net/10138/297808

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Heikkinen , S , Miettinen , J , Pukkala , E , Koskenvuo , M , Malila , N & Pitkaniemi , J 2017 , ' Impact of major life events on breast-cancer-specific mortality : A case fatality study on 8000 breast cancer patients ' , Cancer Epidemiology , vol. 48 , pp. 62-69 . https://doi.org/10.1016/j.canep.2017.03.008

Title: Impact of major life events on breast-cancer-specific mortality : A case fatality study on 8000 breast cancer patients
Author: Heikkinen, Sanna; Miettinen, Joonas; Pukkala, Eero; Koskenvuo, Markku; Malila, Nea; Pitkaniemi, Janne
Contributor: University of Helsinki, Markku Koskenvuo / Principal Investigator
University of Helsinki, Department of Public Health
Date: 2017-06
Language: eng
Number of pages: 8
Belongs to series: Cancer Epidemiology
ISSN: 1877-7821
URI: http://hdl.handle.net/10138/297808
Abstract: Background: It has been suggested that long-term activation of the body's stress-response system and subsequent overexposure to stress hormones may be associated with increased morbidity. However, evidence on the impact of major life events on mortality from breast cancer (BC) remains inconclusive. The main aim of this study is to investigate whether major negatively or positively experienced life events before or after diagnosis have an effect on BC-specific mortality in women who have survived with BC for at least 2 years. Methods: We conducted a case fatality study with data on life events from a self-administered survey and data on BC from the Finnish Cancer Registry. Cox models were fitted to estimate BC mortality hazard ratios (MRs) between those who have undergone major life events and those who haven't. Results: None of the pre-diagnostic negative life events had any effect on BC-specific mortality. Regarding post-diagnostic events, the effect was greatest in women with moderate scores of events. As for event-specific scores, increased BC mortality was observed with spouse unemployment, relationship problems, and death of a close friend. By contrast, falling in love and positive developments in hobbies were shown to be associated with lower BC mortality (MRs 0.67, 95% CI: 0.49-0.92 and 0.74, 95% CI: 0.57-0.96, respectively). In an analysis restricted to recently diagnosed cases (2007), also death of a child and of a mother was associated with increased BC mortality. Conclusions: Some major life events regarding close personal relationships may play a role in BC-specific mortality, with certain negative life events increasing BC mortality and positive events decreasing it. The observed favorable associations between positive developments in romantic relationships and hobbies and BC mortality are likely to reflect the importance of social interaction and support. (C) 2017 Elsevier Ltd. All rights reserved.
Subject: Life events
Stress
Breast cancer
Oncology
Mortality
Epidemiology
Social support
NATURAL-KILLER-CELLS
PSYCHOSOCIAL FACTORS
FOLLOW-UP
NK CELLS
SURVIVAL
HEALTH
RISK
3122 Cancers
3142 Public health care science, environmental and occupational health
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