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Meta-Analysis
. 2024 May 15;154(10):1745-1759.
doi: 10.1002/ijc.34852. Epub 2024 Jan 30.

Psychosocial factors, health behaviors and risk of cancer incidence: Testing interaction and effect modification in an individual participant data meta-analysis

Maartje Basten  1   2   3   4 , Kuan-Yu Pan  3   5   6 , Lonneke A van Tuijl  7   8 , Alexander de Graeff  9 , Joost Dekker  3   5 , Adriaan W Hoogendoorn  3   5 , Femke Lamers  3   5 , Adelita V Ranchor  7 , Roel Vermeulen  10 , Lützen Portengen  10 , Adri C Voogd  11   12 , Jessica Abell  13 , Philip Awadalla  14   15   16 , Aartjan T F Beekman  3   5 , Ottar Bjerkeset  17   18 , Andy Boyd  19 , Yunsong Cui  20 , Philipp Frank  13 , Henrike Galenkamp  21 , Bert Garssen  7 , Sean Hellingman  22 , Martijn Huisman  23   24   25 , Anke Huss  10 , Melanie R Keats  26 , Almar A L Kok  3   5   23   25 , Steinar Krokstad  27   28 , Flora E van Leeuwen  29 , Annemarie I Luik  30 , Nolwenn Noisel  31 , Yves Payette  31 , Brenda W J H Penninx  3   5 , Ina Rissanen  1 , Annelieke M Roest  32 , Judith G M Rosmalen  33   34 , Rikje Ruiter  30   35 , Robert A Schoevers  34 , David Soave  14   22 , Mandy Spaan  29 , Andrew Steptoe  13 , Karien Stronks  21   36 , Erik R Sund  17   27   28 , Ellen Sweeney  20 , Emma L Twait  1 , Alison Teyhan  19 , W M Monique Verschuren  1   37 , Kimberly D van der Willik  29   30 , Mirjam I Geerlings  1   25   38   39   40
Affiliations
Meta-Analysis

Psychosocial factors, health behaviors and risk of cancer incidence: Testing interaction and effect modification in an individual participant data meta-analysis

Maartje Basten et al. Int J Cancer. .

Abstract

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.

Keywords: cancer incidence; health behaviors; individual participant data meta-analysis; interaction/effect modification; psychosocial factors.

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References

REFERENCES

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