Stressful life events and difficulties and onset of breast cancer: case-control study

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Abstract
Objective: To determine the relation between stressful life events and difficulties and the onset of breast cancer. Design: Case-control study. Setting: 3 NHS breast clinics serving west Leeds. Participants: 399 consecutive women, aged 40-79, attending the breast clinics who were Leeds residents. Main outcome measures: Odds ratios of the risk of developing breast cancer after experiencing one or more severe life events, severe difficulties, severe 2 year non-personal health difficulties, or severe 2 year personal health difficulties in the 5 years before clinical presentation. Results: 332 (83%) women participated. Women diagnosed with breast cancer were no more likely to have experienced one or more severe life events (adjusted odds ratio 0.91, 95% confidence interval 0.47 to 1.81; P=0.79); one or more severe difficulties (0.86, 0.41 to 1.81; P=0.69); a 2 year severe non-personal health difficulty (0.53, 0.12 to 2.31; P=0.4); or a 2 year severe personal health difficulty (2.73, 0.68 to 10.93; P=0.16) than women diagnosed with a benign breast lump. Conclusion: These findings do not support the hypothesis that severe life events or difficulties are associated with onset of breast cancer. Although there is widespread belief that stress can cause cancer, research evidence is contradictory Stressful life experiences are common; about two thirds of women with a breast lump experienced at least one severe life event or difficulty in the 5 years before presentation Women diagnosed with breast cancer were no more likely to have experienced a severe stressor than women with a benign lesion Knowledge or suspicion of the diagnosis did not influence reporting of severe life events