Association between allostatic load and breast cancer risk: a cohort study

Yufan Guan; Jie Shen; Juan Lu; Bernard F Fuemmeler; Lisa S Shock; Hua Zhao

doi:10.1186/s13058-023-01754-w

Association between allostatic load and breast cancer risk: a cohort study

Breast Cancer Res. 2023 Dec 19;25(1):155. doi: 10.1186/s13058-023-01754-w.

Authors

Yufan Guan¹, Jie Shen², Juan Lu¹, Bernard F Fuemmeler¹, Lisa S Shock³, Hua Zhao⁴

Affiliations

¹ Departments of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23284, USA.
² Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA, 22903, USA.
³ Departments of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23284, USA.
⁴ Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA, 22903, USA. qqx7mw@virginia.edu.

Abstract

Background: Allostatic load (AL) reflects the collective load of chronic stress during lifetime. Previous studies have shown that higher AL is associated with poor clinical outcomes among breast cancer patients. However, the relationship between AL and breast cancer risk is still unclear.

Methods: To fill the gap, we analyzed the association between AL and the development of breast cancer in 181,455 women identified from the UK Biobank.

Results: During the follow-up from 2006 to 2020, 5,701 women were diagnosed with incident breast cancer. Significantly higher AL was observed among incident breast cancer cases than all study participants (mean: 2.77 vs. 2.63, P < 0.01). Univariate Cox regression analysis indicated the risk of breast cancer was increased by 5% per one AL unit increase (hazard ratio (HR) = 1.05, 95% confidence interval (CI) 1.04, 1.07). In multivariate analyses, after adjusting demographics, family history of breast cancer, reproductive factors, socioeconomic status, lifestyle factors, and breast cancer polygenic risk score (PRS), the significant association remained (HR = 1.05, 95%CI 1.03, 1.07). The significant relationship was further confirmed in the categorical analysis. Compared with women in the low AL group (AL: 0 ~ 2), those in the high AL group (AL: 3 ~ 11) had a 1.17-fold increased risk of breast cancer (HR = 1.17, 95%CI 1.11, 1.24). Finally, in the stratified analysis, joint effects on the risk of breast cancer were observed between the AL and selected known breast cancer risk factors, including age, family history of breast cancer, PRS, income, physical activity, and alcohol consumption.

Conclusion: In summary, those findings have demonstrated that higher AL was associated with an increased breast cancer risk in women. This association is likely independent of known breast cancer risk factors. Thus, the AL could be a valuable biomarker to help breast cancer risk prediction and stratification.

Keywords: Allostatic load; Breast cancer risk; Chronic stress; Cohort study.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Allostasis*
Breast Neoplasms* / epidemiology
Breast Neoplasms* / etiology
Cohort Studies
Exercise
Female
Genetic Risk Score
Humans
Life Style
Risk Factors

Abstract

Publication types

MeSH terms

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