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Cancer Causes Control. 2016 May;27(5):661-8. doi: 10.1007/s10552-016-0739-0. Epub 2016 Mar 29.

A prospective study of phobic anxiety, risk of ovarian cancer, and survival among patients.

Author information

1
Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Ave, 3rd Floor, Boston, MA, 02115, USA. nhlip@channing.harvard.edu.
2
Harvard TH Chan School of Public Health, Boston, MA, USA.
3
MD Anderson Cancer Center, Houston, TX, USA.
4
Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Ave, 3rd Floor, Boston, MA, 02115, USA.

Abstract

PURPOSE:

In ovarian cancer patients and mouse models, psychosocial stress is associated with higher circulating markers of angiogenesis and cell migration, impaired immune response, and increasing tumor burden and aggressiveness. In the Nurses' Health Studies (NHS/NHSII), we assessed whether phobic anxiety, a marker of chronic distress, was associated with risk of incident ovarian cancer as well as survival among ovarian cancer patients.

METHODS:

We used Cox proportional hazards regression to model the relative risks (RRs) and 95 % confidence intervals (CI) of ovarian cancer incidence and survival by categories of the Crown-Crisp phobic anxiety index (CCI).

RESULTS:

We identified 779 cases of ovarian cancer during 2,497,892 person-years of follow-up. For baseline CCI (NHS: 1988; NHSII: 1993), we observed a statistically nonsignificant increased risk of epithelial ovarian cancer (RR for CCI ≥ 4 vs. 0 or 1: 1.14; 95 % CI 0.96-1.36). However, when we updated CCI (NHS: 2004; NHSII: 2005), the associations were attenuated. Pre-diagnosis CCI was not associated with ovarian cancer survival (RR for ≥4 vs. 0 or 1: 1.00; 95 % CI 0.77-1.31); results were similar for post-diagnosis CCI.

CONCLUSIONS:

Distress, as measured by phobic anxiety symptoms, was not associated with ovarian cancer risk, although we cannot rule out a modest association. Future research should explore the role of phobic anxiety and other forms of psychological distress and ovarian cancer risk and survival.

KEYWORDS:

Anxiety; Cancer; Distress; Oncology; Ovarian cancer

PMID:
27023470
PMCID:
PMC4840033
DOI:
10.1007/s10552-016-0739-0
[Indexed for MEDLINE]
Free PMC Article

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