Striking life events associated with primary breast cancer susceptibility in women: a meta-analysis study

Yan Lin, Changjun Wang, Ying Zhong, Xin Huang, Li Peng, Guangliang Shan, Ke Wang, Qiang Sun, Yan Lin, Changjun Wang, Ying Zhong, Xin Huang, Li Peng, Guangliang Shan, Ke Wang, Qiang Sun

Abstract

Purpose: The association between striking life events, an important stress and acute anxiety disorder, and the occurrence of primary breast cancer is unclear. The current meta-analysis was designed to assess the relationship between striking life events and primary breast cancer incidence in women.

Methods: Systematic computerized searching of the PubMed, ScienceDirect, Embase, and BMJ databases with the combinations of controlled descriptors from Mesh, including breast cancer, breast tumor, cancer of breast, mammary carcinoma, life events, life change events, case-control studies, case-base studies, cohort study, and cohort analysis and identified a total of 307 papers published from January 1995 to April 2012. Following evaluation of methodological quality with the Downs & Black criteria, seven case-control or cohort studies were selected and the association between striking life events and primary breast cancer incidence in women was measured using random effect or fixed-effect odds ratios combined with 95% confidence interval.

Results: The seven studies included in the final meta-analysis included 99,807 women. A meta-analysis showed that the pooled OR for striking life events and breast cancer was 1.51 (95% CI 1.15 - 1.97, P = 0.003), indicating that women with striking life events were at 1.5-fold greater risk of developing breast cancer. The pooled OR for severe striking life events and breast cancer was 2.07 (95% CI 1.06 - 4.03), indicating that women with severe striking life events were at 2-fold greater risk of developing breast cancer.

Conclusions: The current meta-analysis showed significant evidence for a positive association between striking life events and primary breast cancer incidence in women.

Figures

Figure 1
Figure 1
Meta-analysis of the relative risk, or odds ratio, for the association between striking life events and primary breast cancer incidence. Solid squares represent risk estimates for the individual studies, with the size of the squares proportional to the sample size and the number of events. Horizontal lines denote 95% confidence intervals (CIs). The diamond shows the confidence interval for the pooled relative risks. Positive values indicate an increased relative risk for primary breast cancer development. Test for overall effect: Z = 2.99, P < 0.01; chi-square test for heterogeneity = 80.53, degrees of freedom = 6, P < 0.001; I2 = 93%.
Figure 2
Figure 2
Meta-analysis of the relative risk, or odds ratio, for the association between severe striking life events and primary breast cancer incidence. Solid squares represent risk estimates for the individual studies. The size of the squares is proportional to the sample size and the number of events. The horizontal lines denote 95% confidence intervals (CIs). The diamond shows the confidence interval for the pooled relative risks. Positive values indicate an increased relative risk for primary breast cancer incidence. Test for overall effect: Z = 2.23, P < 0.01; chi-square test for heterogeneity = 123.79, degrees of freedom = 5, P < 0.001; I2 = 96%.

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