Caregiving stress, endogenous sex steroid hormone levels, and breast cancer incidence

Am J Epidemiol. 2004 Jun 1;159(11):1019-27. doi: 10.1093/aje/kwh148.

Abstract

Stress is hypothesized to be a risk factor for breast cancer. The authors examined associations of hours of, and self-reported levels of stress from, informal caregiving with prospective breast cancer incidence. Cross-sectional analyses of caregiving and endogenous sex steroid hormones were also conducted. In 1992 or 1996, 69,886 US women from the Nurses' Health Study, aged 46-71 years at baseline, answered questions on informal caregiving; 1,700 incident breast cancer cases accrued over follow-up to 2000. A subset of 665 postmenopausal women not taking exogenous hormones returned a blood sample in 1990. Numbers of hours of care provided to an ill adult or to a child were each summed and analyzed as 0 (reference), 1-14, and >/=15 per week. Cox proportional hazards models were used in prospective analyses and linear models in cross-sectional analyses. High numbers of caregiving hours and self-reported stress did not predict a higher incidence of breast cancer. However, compared with women providing no adult care, women providing >/=15 hours of adult care (median, 54) had significantly lower levels of estradiol (geometric mean, 9.21 pg/ml vs. 7.46 pg/ml (95% confidence interval: 6.36, 8.76)) and bioavailable estradiol (geometric mean, 1.86 pg/ml vs. 1.35 pg/ml (95% confidence interval: 1.00, 1.82)). Stress from caregiving did not appear to increase breast cancer risk.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Breast Neoplasms / blood
  • Breast Neoplasms / epidemiology*
  • Breast Neoplasms / psychology
  • Caregivers / psychology*
  • Cross-Sectional Studies
  • Female
  • Gonadal Steroid Hormones / blood*
  • Humans
  • Incidence
  • Linear Models
  • Longitudinal Studies
  • Middle Aged
  • Proportional Hazards Models
  • Risk Factors
  • Stress, Psychological / blood
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / psychology

Substances

  • Gonadal Steroid Hormones