TY - JOUR
T1 - Psychosocial factors, health behaviors and risk of cancer incidence
T2 - Testing interaction and effect modification in an individual participant data meta-analysis
AU - Basten, Maartje
AU - Pan, Kuan-Yu
AU - van Tuijl, Lonneke A
AU - de Graeff, Alexander
AU - Dekker, Joost
AU - Hoogendoorn, Adriaan W
AU - Lamers, Femke
AU - Ranchor, Adelita V
AU - Vermeulen, Roel
AU - Portengen, Lützen
AU - Voogd, Adri C
AU - Abell, Jessica
AU - Awadalla, Philip
AU - Beekman, Aartjan T F
AU - Bjerkeset, Ottar
AU - Boyd, Andy
AU - Cui, Yunsong
AU - Frank, Philipp
AU - Galenkamp, Henrike
AU - Garssen, Bert
AU - Hellingman, Sean
AU - Huisman, Martijn
AU - Huss, Anke
AU - Keats, Melanie R
AU - Kok, Almar A L
AU - Krokstad, Steinar
AU - van Leeuwen, Flora E
AU - Luik, Annemarie I
AU - Noisel, Nolwenn
AU - Payette, Yves
AU - Penninx, Brenda W J H
AU - Rissanen, Ina
AU - Roest, Annelieke M
AU - Rosmalen, Judith G M
AU - Ruiter, Rikje
AU - Schoevers, Robert A
AU - Soave, David
AU - Spaan, Mandy
AU - Steptoe, Andrew
AU - Stronks, Karien
AU - Sund, Erik R
AU - Sweeney, Ellen
AU - Twait, Emma L
AU - Teyhan, Alison
AU - Verschuren, W M Monique
AU - van der Willik, Kimberly D
AU - Geerlings, Mirjam I
N1 - Publisher Copyright: © 2024 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.
PY - 2024/1/30
Y1 - 2024/1/30
N2 - 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.
AB - 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.
KW - cancer incidence
KW - health behaviors
KW - individual participant data meta-analysis
KW - interaction/effect modification
KW - psychosocial factors
UR - http://www.scopus.com/inward/record.url?scp=85183901589&partnerID=8YFLogxK
U2 - 10.1002/ijc.34852
DO - 10.1002/ijc.34852
M3 - Article
C2 - 38289012
SN - 0020-7136
VL - 154
SP - 1745
EP - 1759
JO - International journal of cancer
JF - International journal of cancer
IS - 10
ER -