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Perceived stress and risk of colorectal cancer in men and women: a prospective cohort study
Authors:Nielsen N R  Kristensen T S  Strandberg-Larsen K  Zhang Z-F  Schnohr P  Grønbaek M
Institution:From the National Institute of Public Health, Copenhagen, Denmark;, Department of Epidemiology, UCLA School of Public Health, Los Angeles, USA;, National Institute of Occupational Health, Copenhagen, Denmark;, and The Copenhagen City Heart Study, Epidemiological Research Unit, Bispebjerg University Hospital, Copenhagen, Denmark
Abstract:Objective. We aim to assess the relationship between stress and risk of primary colorectal cancer in men and women. Design. A prospective cohort study Setting. The Copenhagen City Heart Study, Denmark Subjects. A total of 6488 women and 5426 men were included in the study. The participants were asked about intensity and frequency of stress at baseline in 1981–1983 and were followed until the end of 2000 in the Danish Cancer Registry. Less than 0.1% was lost to follow‐up. Main outcome measures. First time incidence of primary colorectal cancer. Results. During follow‐up 162 women and 166 men were diagnosed with colorectal cancer. Women with moderate and high stress intensity had a hazard ratio of 0.60 (95% CI: 0.37–0.98) and 0.52 (0.23–1.14) for colorectal cancer, respectively, compared to women with no stress. For colon cancer, a one‐unit increase on a seven‐point stress‐score was associated with an 11% lower incidence of the disease (HR = 0.89, 95% CI: 0.81–0.99) amongst women. There was no consistent evidence of an association between stress and colorectal cancer in men. Conclusion. Perceived stress was associated with lower risk of particularly colon cancer in women, whilst there was no clear relationship between stress and colorectal cancer in men.
Keywords:colorectal neoplasms  prospective studies  psychological stress
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