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Cancer incidence and mortality following exposures to distal and proximal major stressors

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

Severe psychological trauma has been shown to leave psychological and biological sequelae, including compromise of the neuro-hormonal and immunological systems. Despite much research, the putative effect of such stressor on cancer remains ambiguous. This study maximized the exploration of cancer incidence and mortality by combining a proximal (parental bereavement) with a distal major stressor (Holocaust exposure) on both risks.

Methods

Subjects were bereaved Holocaust survivors (n = 904) and comparison individuals (n = 933) selected from the total cohort of 6,284 Jewish-Israeli parents who lost an adult son in war or from non-self-inflicted external causes. Cox regression was used to examine the differential risk for cancer between the two bereaved samples, adjusting for potential confounders.

Results

No difference in cancer incidence or mortality was observed between both groups of bereaved parents. However, prior to bereavement, Holocaust survivors had an increased cancer risk compared with their counterparts in the general population.

Conclusions

Individuals who faced both a proximal (bereavement) and distal (Holocaust) major stressors had no additive risk for cancer incidence and mortality.

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Acknowledgments

This study was supported in part by grant 1-RO1CA62451-01 from the National Cancer Institute, National Institutes of Health, US.

Conflict of interest

The authors declare that they have no conflict of interests.

Author information

Authors and Affiliations

  1. Department of Psychiatry and Human Behavior, The Warren Alpert School of Medicine at Brown University, Providence, RI, USA

    Robert Kohn

  2. Faculty of Social Welfare and Health Sciences, School of Community Mental Health, University of Haifa, Haifa, Israel

    Itzhak Levav

  3. Israel National Cancer Registry, Ministry of Health, Jerusalem, Israel

    Irena Liphshitz & Micha Barchana

  4. Faculty of Social Welfare and Health Sciences, School of Public Health, University of Haifa, Haifa, Israel

    Micha Barchana & Lital Keinan-Boker

  5. Israel Center for Disease Control, Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hshomer, Ramat Gan, 52621, Israel

    Lital Keinan-Boker

Authors
  1. Robert Kohn
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  2. Itzhak Levav
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  3. Irena Liphshitz
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  4. Micha Barchana
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  5. Lital Keinan-Boker
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Corresponding author

Correspondence to Lital Keinan-Boker.

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Kohn, R., Levav, I., Liphshitz, I. et al. Cancer incidence and mortality following exposures to distal and proximal major stressors. Soc Psychiatry Psychiatr Epidemiol 49, 703–709 (2014). https://doi.org/10.1007/s00127-013-0805-9

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  • DOI: https://doi.org/10.1007/s00127-013-0805-9

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