Published in

American Association for Cancer Research, Cancer Epidemiology, Biomarkers & Prevention, 2(28), p. 400-408, 2019

DOI: 10.1158/1055-9965.epi-18-0451

Links

Tools

Export citation

Search in Google Scholar

Stress Resilience in Late Adolescence and Survival among Cancer Patients: A Swedish Register-Based Cohort Study

This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

Full text: Download

Green circle
Preprint: archiving allowed
Orange circle
Postprint: archiving restricted
Red circle
Published version: archiving forbidden
Data provided by SHERPA/RoMEO

Abstract

Abstract Background: Chronic stress has been suggested to play a role in cancer progression, but few studies have so far examined the potential influence of stress susceptibility. This national register-based cohort study utilizes a unique data source to investigate whether a stress resilience measure is associated with survival in cancer patients. Methods: The cohort includes 9,318 Swedish male cancer patients born during 1952 to 1956 who had their stress resilience evaluated at a semistructured interview with a psychologist during mandatory conscription examination in late adolescence. Results: Over a median of 3 years of follow-up from cancer diagnosis, a total of 2,541 patients died (2,322 from cancer). Overall, low (23%) compared with high (25%) stress resilience was associated with increased mortality (adjusted hazard ratio estimated by Cox regression 1.45; 95% confidence interval 1.28–1.65), particularly among men with carcinomas of the oropharynx (2.62, 1.24–5.56), upper respiratory tract (4.64, 1.05–20.41), and prostate (2.20, 1.04–4.62), as well as with Hodgkin lymphoma (3.52, 1.40–8.86). An association was evident for both cancer types associated with smoking (1.35, 1.10–1.66) and malignancies without an established smoking etiology (1.32, 1.12–1.56). The association between low stress resilience and mortality could partly be explained by tumor stage, marital status, and psychiatric comorbidity at cancer diagnosis. Conclusions: We observed an association between low stress resilience and mortality among men diagnosed with cancer, particularly oropharyngeal cancer, upper respiratory tract cancers, prostate cancer, and Hodgkin lymphoma. Impact: These results suggest that individual variation in stress resilience may influence survival among men with some cancer types.