Background: Major stressful life events have been shown to be associated with an increased risk of lung cancer, breast cancer and the development of various chronic illnesses. The stress response generated by our body results in a variety of physiological and metabolic changes which can affect the immune system and have been shown to be associated with tumor progression. In this study, we aim to determine if major stressful life events are associated with the incidence of head and neck or pancreatic cancer (HNPC). Methods: This is a matched case–control study. Cases (CAs) were HNPC patients diagnosed within the previous 12 months. Controls (COs) were patients without a prior history of malignancy. Basic demographic data information on major stressful life events was collected using the modified Holmes–Rahe stress scale. A total sample of 280 was needed (79 cases, 201 controls) to achieve at least 80% power to detect odds ratios (ORs) of 2.00 or higher at the 5% level of significance. Results: From 1 January 2018 to 31 August 2021, 280 patients were enrolled (CA = 79, CO = 201) in this study. In a multivariable logistic regression analysis after controlling for potential confounding variables (including sex, age, race, education, marital status, smoking history), there was no difference between the lifetime prevalence of major stressful event in cases and controls. However, patients with HNPC were significantly more likely to report a major stressful life event within the preceding 5 years when compared to COs (p= 0.01, OR = 2.32, 95% CI, 1.18–4.54). Conclusions: Patients with head, neck and pancreatic cancers are significantly associated with having a major stressful life event within 5 years of their diagnosis. This study highlights the potential need to recognize stressful life events as risk factors for developing malignancies.
背景：已有研究表明，重大应激性生活事件与肺癌、乳腺癌风险增加及多种慢性疾病的发生相关。人体产生的应激反应会导致多种生理和代谢变化，这些变化可能影响免疫系统，并已被证实与肿瘤进展相关。本研究旨在探讨重大应激性生活事件是否与头颈癌或胰腺癌（HNPC）的发病率存在关联。方法：本研究采用匹配病例对照设计。病例组（CAs）为过去12个月内确诊的HNPC患者，对照组（COs）为无恶性肿瘤病史的患者。通过改良版Holmes-Rahe应激量表收集基本人口统计学数据及重大应激性生活事件信息。为达到至少80%的检验效能，在5%显著性水平上检测比值比（OR）≥2.00的效应，共需280例样本（79例病例，201例对照）。结果：2018年1月1日至2021年8月31日期间，共纳入280例患者（CA=79例，CO=201例）。在控制潜在混杂变量（包括性别、年龄、种族、教育程度、婚姻状况、吸烟史）的多变量逻辑回归分析中，病例组与对照组的终生重大应激事件发生率无显著差异。然而，与对照组相比，HNPC患者在确诊前5年内经历重大应激性生活事件的比例显著更高（p=0.01，OR=2.32，95% CI：1.18-4.54）。结论：头颈癌和胰腺癌患者在确诊前5年内经历重大应激性生活事件的比例显著更高。本研究提示，有必要将应激性生活事件视为恶性肿瘤发生的潜在风险因素。
Major Stressful Life Events and the Risk of Pancreatic, Head and Neck Cancers: A Case–Control Study
肿瘤(癌症)患者之家