Influence of stressors on breast cancer incidence in the Women's Health Initiative
AuthorsMichael, Yvonne L.
Carlson, Nichole E.
Chlebowski, Rowan T.
Weihs, Karen L.
Ockene, Judith K.
Bowen, Deborah J.
UMass Chan AffiliationsDepartment of Medicine, Division of Preventive and Behavioral Medicine
Document TypeJournal Article
*Life Change Events
Proportional Hazards Models
Medicine and Health Sciences
MetadataShow full item record
AbstractOBJECTIVE: To examine associations among life events stress, social support, and breast cancer incidence in a cohort of postmenopausal women. DESIGN AND MAIN OUTCOME MEASURE: Women's Health Initiative observational study participants, breast cancer free at entry, who provided assessment of stressful life events, social support, and breast cancer risk factors, were prospectively followed for breast cancer incidence (n = 84,334). RESULTS: During an average of 7.6 years of follow-up, 2,481 invasive breast cancers were diagnosed. In age-adjusted proportional hazards models, 1 stressful life event was associated with increased risk, but risk decreased with each additional stressful life event. After adjustment for confounders the decreasing risk was not significant. Stressful life events and social support appeared to interact in relation to breast cancer risk such that women who had greater number of stressful life events and low social support had a decreased risk of breast cancer. CONCLUSIONS: This study found no independent association between stressful life events and breast cancer risk. The results are compatible with a more complex model of psychosocial factors interacting in relation to breast cancer risk.
Health Psychol. 2009 Mar;28(2):137-46. Link to article on publisher's site
Permanent Link to this Itemhttp://hdl.handle.net/20.500.14038/50966
Showing items related by title, author, creator and subject.
VHA Health Care in Response to a New Generation of Female VeteransKimerling, Rachel; Haskell, Sally; Maguen, Shira; Mattocks, Kristin M.; Garrett-Ray, Stacy; Veet, Laure; McCutcheon, Susan (2013-01-01)This book surveys critical aspects of modern military health care in the US and various other Western countries with troops in Iraq and Afghanistan. This book covers health care issues prior to deployment, such as screening for mental health, evaluating long-term consequences of exposure to military service, and provision of insurance; care during a conflict, primarily battlefield clinics, battlefield trauma care, and evacuation procedures; and post- combat care, including serious war injuries, psychiatric, and long-term care. Bringing together research from a wide range of contributors, the volume provides readers with an extensive, up-to-date source of information on military medicine.
Epidemiologic and diagnostic aspects of bacteriuria: a longitudinal study in older women.Monane, Mark; Gurwitz, Jerry H.; Lipsitz, Lewis A.; Glynn, Robert J.; Choodnovskiy, Igor; Avorn, Jerry (1995-06-01)OBJECTIVE: To examine month-by-month variability of bacteriuria in a cohort of older women and to evaluate the performance of rapid diagnostic tests commonly used to indicate the presence of significant bacteriuria. DESIGN: Prospective, observational study. SETTING: Community housing sites and a long-term care institution. PARTICIPANTS: Sixty-one women, mean age 77.6, took part in the study. MEASUREMENTS: Midstream clean-catch urine samples and medical information on subjects were collected at baseline, and then monthly for 6 months. RESULTS: Bacteriuria alone (> or = 10(5) organisms per mL) occurred in 17% of all urine samples (28% of patients), bacteriuria with pyuria in 15% (26% of patients), and bacteriuria with symptoms in 3% (10% of patients). Spontaneous clearance of bacteriuria with pyuria was common (P = .30), as were new occurrences (P = .12) over 6 months of follow-up. For the outcome of bacteriuria with symptoms, sensitivity of urinary diagnostic tests such as bacteria and pyuria on microscopic analysis, and leukocyte esterase on dipstick testing, ranged from 79 to 93%. Negative predictive values of these tests approached 100%. CONCLUSIONS: Bacteriuria was a very common event, occurring in almost one-fifth of all urine samples and one-third of all subjects during 6 months of follow-up. Month-by-month follow-up indicates that the natural history of bacteriuria is marked by frequent spontaneous alternation between positive and negative events. The high negative predictive value of many simple diagnostic tests commonly used for urinary tract disease suggests that they can quickly and cost-effectively rule out bacteriuria in the older female patient.
Obesity is not protective against fracture in postmenopausal women: GLOWCompston, Juliet E.; Watts, Nelson B.; Chapurlat, Roland D.; Cooper, Cyrus; Boonen, Steven; Pfeilschifter, Johannes; Silverman, Stuart; Diez-Perez, Adolfo; Lindsay, Robert; Saag, Kenneth G.; et al. (2011-11-25)OBJECTIVE: To investigate the prevalence and incidence of clinical fractures in obese, postmenopausal women enrolled in the Global Longitudinal study of Osteoporosis in Women (GLOW). METHODS: This was a multinational, prospective, observational, population-based study carried out by 723 physician practices at 17 sites in 10 countries. A total of 60,393 women aged >/= 55 years were included. Data were collected using self-administered questionnaires that covered domains that included patient characteristics, fracture history, risk factors for fracture, and anti-osteoporosis medications. RESULTS: Body mass index (BMI) and fracture history were available at baseline and at 1 and 2 years in 44,534 women, 23.4% of whom were obese (BMI >/= 30 kg/m(2)). Fracture prevalence in obese women at baseline was 222 per 1000 and incidence at 2 years was 61.7 per 1000, similar to rates in nonobese women (227 and 66.0 per 1000, respectively). Fractures in obese women accounted for 23% and 22% of all previous and incident fractures, respectively. The risk of incident ankle and upper leg fractures was significantly higher in obese than in nonobese women, while the risk of wrist fracture was significantly lower. Obese women with fracture were more likely to have experienced early menopause and to report 2 or more falls in the past year. Self-reported asthma, emphysema, and type 1 diabetes were all significantly more common in obese than nonobese women with incident fracture. At 2 years, 27% of obese women with incident fracture were receiving bone protective therapy, compared with 41% of nonobese and 57% of underweight women. CONCLUSIONS: Our results demonstrate that obesity is not protective against fracture in postmenopausal women and is associated with increased risk of ankle and upper leg fractures.