Wear and tear from a lifetime of stress can lead to an increased risk of dying from cancer

Wear and tear from a lifetime of stress can lead to an increased risk of dying from cancer

The wear and tear on the body from chronic and lifelong stress can also lead to an increased risk of dying from cancer, researchers at the Medical College of Georgia report.

This wear and tear, called allostatic load, refers to the cumulative effects of stress over time.

In response to external stressors, your body releases a stress hormone called cortisol. As soon as the stress is over, these values ​​should decrease again. However, if you suffer from chronic, persistent psychosocial stressors that never allow you to “wind down,” this can cause wear and tear on your body at a biological level.”

Dr. Justin Xavier Moore, epidemiologist, Medical College of Georgia and Georgia Cancer Center

Researchers led by Moore conducted a retrospective analysis of more than 41,000 people from the National Health and Nutrition Examination Survey (NHANES) collected between 1988 and 2019. This database contains basic biological measurements of participants -; Body mass index, diastolic and systolic blood pressure, total cholesterol, hemoglobin A1C (higher levels indicate risk of diabetes), albumin and creatinine (both measures of kidney function), and C-reactive protein (a measure of inflammation) -; which the researchers used to determine allostatic load. Those with a score greater than 3 were classified as having high allostatic load.

They then compared those participants to the National Death Index, maintained by the National Center for Health Statistics and the Centers for Disease Control and Prevention, to determine which people died of cancer and when, Moore explains.

“To date, there is limited research on the association between allostatic load and cancer in a contemporary, nationally representative sample of U.S. adults,” Moore and colleagues write in the journal SSM Population Health. “Investigating the association of allostatic load with cancer outcomes and whether these associations vary by race could shed light on new approaches to mitigating cancer disparities.”

The researchers found that even without accounting for potential confounding factors such as age, social demographics such as race and gender, poverty-to-income ratio, and education level, those with high allostatic loads were 2.4 times more likely to die from cancer than those with low allostatic loads.

“But you have to be prepared for disruptive factors,” explains Moore. “We know that there are differences in allostatic load depending on age, race and gender.”

In fact, in previous research, he and his colleagues observed that when looking at trends in allostatic load over 30 years in 50,671 people, adults aged 40 and older had a more than 100% increased risk of high allostatic load compared to adults under 30. Additionally, regardless of time period, Black and Latino adults had an increased risk of high allostatic load compared to their white counterparts. Much of this, says Moore, can be attributed to structural racism -; Things like difficulty finding better educational opportunities or fair and equitable home loans.

“If you are born into an environment where your opportunities are very different than those of your white male counterparts, for example as a black woman, you will have to deal with more adversity over the course of your life,” he says.

Even taking age into account, the researchers found that people with high allostatic load still had a 28% increased risk of dying from cancer. “This means that if two people of the same age had high allostatic load, they would be 28% more likely to die from cancer,” says Moore.

Adjusting for sociodemographic factors such as gender, race, and education level, high allostatic load resulted in a 21% increase; and further adjusting the model for other risk factors, such as whether participants had smoked, previously had a heart attack, or been previously diagnosed with cancer or heart failure, resulted in a 14% increase.

Moore and colleagues also examined the association between allostatic load and cancer mortality specifically in each racial/ethnic group (e.g., non-Hispanic blacks, non-Hispanic whites, and Hispanic adults). However, when broken down by racial category, the association between allostatic load was not as strong. These results could be explained by the sheer size of the original sample.

“Epidemiologically, if you look at 41,000 people, there are a lot of cancer-related deaths,” explains Moore. “However, it is more difficult to establish a relationship between x (allostatic load) and y (death from cancer) when you essentially have fewer data points to measure.” For example, limiting the sample to non-Hispanic blacks would mean analyzing a sample of only 11,000 people, so the relationship may appear diminished or attenuated.

“The reason race matters at all is because there are systemic factors that disproportionately affect people of color,” he says. “But even if you ignore race, the bottom line is that the environments we live, work and play in, where you are rewarded for working harder and are sometimes seen as weak for taking time for yourself, lead to high levels of stress that lead to this.” This, in turn, can lead to cancer development and increased morbidity and mortality.”

In the United States, cancer is the second leading cause of death, accounting for an estimated 1.9 million cases and nearly 609,000 deaths in 2021.

Source:

Medical College of Georgia at Augusta University

Reference:

Burden and cancer mortality: A retrospective cohort analysis of NHANES, 1988 to 2019. SSM - Population Health. doi.org/10.1016/j.ssmph.2022.101185.

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