Symptoms of PTSD appeared associated with increased risk for ovarian cancer, especially among premenopausal women, according to study results published in Cancer Research.
“In light of these findings, we need to understand whether successful treatment of PTSD would reduce this risk, and whether other types of stress are also risk factors for ovarian cancer,” Andrea Roberts, PhD, MPH, study co-author and research scientist at Harvard T.H. Chan School of Public Health, said in a press release.
Roberts and colleagues analyzed data from 49,443 women (mean age, 34.6 years; 95.7% white) in the Nurses’ Health Study II who were followed for up to 26 years between 1989 and 2015.
The researchers validated self-reported ovarian cancer with medical records. They estimated risks for ovarian cancer with Cox proportional hazard models adjusted for known ovarian cancer and health risk factors.
In a supplemental questionnaire administered in 2008, the women reported lifetime PTSD symptoms from traumatic events, such as car accidents or assaults. They also identified the event they viewed as most stressful and the year of that event, as well as seven PTSD symptoms associated with the event.
Researchers organized women into six groups according to PTSD symptoms following their worst trauma. Groups included no trauma exposure (reference group), trauma and no PTSD symptoms, one to three PTSD symptoms (subclinical), four to five symptoms (moderate), six to seven symptoms (high) and trauma with PTSD symptoms unknown.
Researchers also examined associations by menopausal status.
During follow-up, 110 cases of ovarian cancer occurred across 1.15 million person-years.
Results showed that women with high PTSD symptoms had double the risk for ovarian cancer compared with women who had no trauma exposure (age-adjusted HR = 2.1; 95% CI, 1.12-3.95).
The association weakened only moderately after adjustment for health risk factors, such as smoking, and ovarian cancer risk factors, such as hormonal factors (HR = 1.86; 95% CI, 0.98-3.51).
Separate analyses showed similar or stronger associations of high PTSD symptoms and ovarian cancer risk among women who had not been diagnosed with ovarian cancer at the time of the 2008 PTSD assessment (n = 50; age-adjusted HR = 2.38; 95% CI, 0.98-5.76) and among premenopausal women (HR = 3.42; 95% CI, 1.08-10.85).
“Ovarian cancer has relatively few known risk factors. PTSD and other forms of distress, like depression, may represent a novel direction in ovarian cancer prevention research,” Shelley Tworoger, PhD, study co-author and associate director of population science at Moffitt Cancer Center, said in a press release. “If confirmed in other populations, this could be one factor that doctors could consider when determining if a woman is at high risk [for] ovarian cancer.” – by John DeRosier
Disclosures: The authors report no relevant financial disclosures.