Association between stress, depression or anxiety and cancer: Rapid review of reviews

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

Comprehensive psychoneuroendocrinology Pub Date : 2023-11-01 DOI:10.1016/j.cpnec.2023.100215

Katy Cooper , Fiona Campbell , Sue Harnan , Anthea Sutton

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Abstract

Background

Several studies have suggested links between psychological stress, depression or anxiety, and cancer incidence or outcomes. Existing systematic reviews have addressed this question, with differing results.

Aims

This rapid systematic umbrella review summarises existing reviews assessing the association between psychological stress, depression or anxiety and cancer incidence or cancer outcomes.

Methods

Systematic reviews assessing stress, depression or anxiety and cancer were identified via searches of MEDLINE, PsycInfo and Cochrane Database of Systematic Reviews from 2010 to November 2020.

Results

Twelve systematic reviews were included, summarising cohort and case-control studies, most of which adjusted for confounders. Regarding cancer incidence, one large meta-analysis reported a significant association between depression/anxiety and cancer incidence, while another showed a non-significant trend. Two further meta-analyses reported significant associations between stressful life events and cancer incidence. Conversely, two meta-analyses of work stress showed no significant association with cancer incidence. Regarding outcomes among cancer patients, three meta-analyses reported significant associations between depression/anxiety and cancer mortality, while another reported a non-significant trend for depression and cancer recurrence. One meta-analysis reported a significant association between partner bereavement and cancer mortality, while another showed no significant association between work stress and cancer mortality.

Conclusions

There is consistent evidence for an association between psychological stress, depression or anxiety and cancer incidence in general populations, and some evidence for an association with mortality in cancer populations. Future research may focus on confirmation of these findings, as well as the role of social support and stress-reducing interventions in buffering against these effects.

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压力、抑郁或焦虑与癌症之间的关系:快速回顾回顾

一些研究表明，心理压力、抑郁或焦虑与癌症发病率或结果之间存在联系。现有的系统评价已经解决了这个问题，但结果不同。本快速系统综述总结了评估心理压力、抑郁或焦虑与癌症发病率或癌症结局之间关系的现有综述。方法通过检索2010年至2020年11月的MEDLINE、PsycInfo和Cochrane系统综述数据库，确定评估压力、抑郁或焦虑与癌症的系统综述。结果纳入12篇系统综述，总结了队列和病例对照研究，其中大部分对混杂因素进行了调整。关于癌症发病率，一项大型荟萃分析报告了抑郁/焦虑与癌症发病率之间的显著关联，而另一项分析则显示了不显著的趋势。两项进一步的荟萃分析报告了压力生活事件与癌症发病率之间的显著关联。相反，两项关于工作压力的荟萃分析显示，工作压力与癌症发病率没有显著关联。关于癌症患者的结果，三项荟萃分析报告了抑郁/焦虑与癌症死亡率之间的显著关联，而另一项分析报告了抑郁和癌症复发之间的非显著趋势。一项荟萃分析报告了伴侣丧失与癌症死亡率之间的显著关联，而另一项分析则显示工作压力与癌症死亡率之间没有显著关联。结论:有一致的证据表明，心理压力、抑郁或焦虑与一般人群的癌症发病率有关，也有一些证据表明与癌症人群的死亡率有关。未来的研究可能会集中在证实这些发现，以及社会支持和减轻压力的干预措施在缓冲这些影响中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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