Psychosocial factors, health behaviors and risk of cancer incidence: Testing interaction and effect modification in an individual participant data meta-analysis.
Maartje BastenKuan-Yu PanLonneke A van TuijlAlexander de GraeffJoost DekkerAdriaan W HoogendoornFemke LamersAdelita V RanchorRoel VermeulenLützen PortengenAdri C VoogdJessica AbellPhilip AwadallaAartjan T F BeekmanOttar BjerkesetAndy BoydYunsong CuiPhilipp FrankHenrike GalenkampBert GarssenSean HellingmanMartijn HuismanAnke HussMelanie R KeatsAlmar A L KokSteinar KrokstadFlora E van LeeuwenAnnemarie I LuikNolwenn NoiselYves PayetteBrenda W J H PenninxIna RissanenAnnelieke M RoestJudith G M RosmalenRikje RuiterRobert A SchoeversDavid SoaveMandy SpaanAndrew SteptoeKarien StronksErik R SundEllen SweeneyEmma L TwaitAlison TeyhanW M Monique VerschurenKimberly D van der WillikMirjam I GeerlingsPublished in: International journal of cancer (2024)
Depression, anxiety and other psychosocial factors are hypothesized to be involved in cancer development. We examined whether psychosocial factors interact with or modify the effects of health behaviors, such as smoking and alcohol use, in relation to cancer incidence. Two-stage individual participant data meta-analyses were performed based on 22 cohorts of the PSYchosocial factors and CAncer (PSY-CA) study. We examined nine psychosocial factors (depression diagnosis, depression symptoms, anxiety diagnosis, anxiety symptoms, perceived social support, loss events, general distress, neuroticism, relationship status), seven health behaviors/behavior-related factors (smoking, alcohol use, physical activity, body mass index, sedentary behavior, sleep quality, sleep duration) and seven cancer outcomes (overall cancer, smoking-related, alcohol-related, breast, lung, prostate, colorectal). Effects of the psychosocial factor, health behavior and their product term on cancer incidence were estimated using Cox regression. We pooled cohort-specific estimates using multivariate random-effects meta-analyses. Additive and multiplicative interaction/effect modification was examined. This study involved 437,827 participants, 36,961 incident cancer diagnoses, and 4,749,481 person years of follow-up. Out of 744 combinations of psychosocial factors, health behaviors, and cancer outcomes, we found no evidence of interaction. Effect modification was found for some combinations, but there were no clear patterns for any particular factors or outcomes involved. In this first large study to systematically examine potential interaction and effect modification, we found no evidence for psychosocial factors to interact with or modify health behaviors in relation to cancer incidence. The behavioral risk profile for cancer incidence is similar in people with and without psychosocial stress.
Keyphrases
- papillary thyroid
- mental health
- sleep quality
- physical activity
- squamous cell
- systematic review
- healthcare
- body mass index
- depressive symptoms
- public health
- social support
- lymph node metastasis
- prostate cancer
- risk factors
- clinical trial
- weight loss
- machine learning
- smoking cessation
- skeletal muscle
- study protocol
- heat stress
- social media
- double blind