Claudia Trudel-Fitzgerald1, Elizabeth M Poole, Annika Idahl, Eva Lundin, Anil K Sood, Ichiro Kawachi, Laura D Kubzansky, Shelley S Tworoger. 1. From the Department of Social and Behavioral Sciences (Trudel-Fitzgerald, Kawachi, Kubzansky), Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine (Poole, Tworoger), Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Clinical Sciences, Obstetrics and Gynecology (Idahl), Umeå University, Umeå, Sweden; Department of Medical Biosciences, Pathology (Lundin), Umeå University, Umeå, Sweden; Department of Gynecologic Oncology and Reproductive Medicine (Sood), Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas; and Department of Epidemiology (Tworoger), Harvard T.H. Chan School of Public Health Boston, Massachusetts.
Abstract
OBJECTIVE: Ovarian cancer (OvCA) is a leading cause of cancer death for women. Depression and social isolation have been associated with a higher OvCA risk and poorer survival, but other forms of chronic psychosocial stress, including work-related characteristics, remain understudied. METHODS: Women from three prospective cohorts (Nurses' Health Study: n = 31,754; Nurses' Health Study II: n = 74,260; Northern Sweden Health and Disease Study: nnested case-control study = 196) completed a job questionnaire, assessing demand and control at work, social support provided by coworkers and supervisor, and job security. Multivariate Cox and conditional logistic regression models estimated hazard ratios (Nurses' Health Study/Nurses' Health Study II) and odd ratios (Northern Sweden Health and Disease Study) of OvCA risk and mortality among cases. Random coefficient models were used for meta-analyses. RESULTS: There were 396 OvCA cases and 186 deaths during follow-up. Overall, job strain, strain chronicity, social support, and job security were not significantly associated with OvCA risk (e.g., pooled relative risk [RR]high demand/low control = 1.06, confidence interval [CI] = 0.72-1.55) or mortality (e.g., pooled RRhigh demand/low control = 1.08, CI = 0.64-1.82). When considered individually, compared with low levels, only moderate levels of demand were associated with a reduced OvCA risk (pooled RR = 0.66, CI = 0.49-0.90). Social support provided by the coworker or the supervisor did not moderate the association of job strain with either OvCA risk or overall mortality. CONCLUSIONS: We did not observe clear associations between work characteristics and OvCA incidence or mortality, but further research with diverse populations is warranted.
OBJECTIVE:Ovarian cancer (OvCA) is a leading cause of cancer death for women. Depression and social isolation have been associated with a higher OvCA risk and poorer survival, but other forms of chronic psychosocial stress, including work-related characteristics, remain understudied. METHODS:Women from three prospective cohorts (Nurses' Health Study: n = 31,754; Nurses' Health Study II: n = 74,260; Northern Sweden Health and Disease Study: nnested case-control study = 196) completed a job questionnaire, assessing demand and control at work, social support provided by coworkers and supervisor, and job security. Multivariate Cox and conditional logistic regression models estimated hazard ratios (Nurses' Health Study/Nurses' Health Study II) and odd ratios (Northern Sweden Health and Disease Study) of OvCA risk and mortality among cases. Random coefficient models were used for meta-analyses. RESULTS: There were 396 OvCA cases and 186 deaths during follow-up. Overall, job strain, strain chronicity, social support, and job security were not significantly associated with OvCA risk (e.g., pooled relative risk [RR]high demand/low control = 1.06, confidence interval [CI] = 0.72-1.55) or mortality (e.g., pooled RRhigh demand/low control = 1.08, CI = 0.64-1.82). When considered individually, compared with low levels, only moderate levels of demand were associated with a reduced OvCA risk (pooled RR = 0.66, CI = 0.49-0.90). Social support provided by the coworker or the supervisor did not moderate the association of job strain with either OvCA risk or overall mortality. CONCLUSIONS: We did not observe clear associations between work characteristics and OvCA incidence or mortality, but further research with diverse populations is warranted.
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