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Risk of infection-related cancers after the loss of a child: a follow-up study in Sweden
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; Department of Epidemiology, Harvard School of Public Health, Boston, USA; Centre of Public Health Sciences, School of Health Sciences, University of Iceland, Reykjavík, Iceland.ORCID iD: 0000-0002-3649-2639
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; Department of Epidemiology, Harvard School of Public Health, Boston, USA.
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2011 (English)In: Cancer Research, ISSN 0008-5472, E-ISSN 1538-7445, Vol. 71, no 1, 116-22 p.Article in journal (Refereed) Published
Abstract [en]

It is unknown whether severe emotional stress due to loss of a child influences the risk of cancers susceptible to immune modulation such as infection-related cancers. We conducted a historic cohort study in 1990 to 2004 on the basis of the Swedish Multi-Generation Register including 4,687,073 parents. Death of a child was identified through the Causes of Death Register. Poisson regression was used to derive the relative risks (RR) and 95% confidence intervals (CI) of infection-related cancers, comparing the incidence rates of parents who lost a child with those who never lost a child. A total of 101,306 parents (2%) had lost a child during follow-up, among whom 1,608 subsequently developed infection-related cancers. After adjustment for age, sex, calendar year, educational level, and civil status, the overall RR of 14 cancers studied was 1.07 (95% CI: 1.02-1.12). Parents who lost a child were particularly at a higher risk for cancers potentially associated with human papilloma virus (HPV) infection such as cervical cancer (RR: 1.46; 95% CI: 1.17-1.80). Higher RRs for most cancers were obtained within 5 years after child loss and excess risk for liver and stomach cancers was confined to that period. No association was observed for lymphoma and nonmelanoma skin cancer at any time point after child loss. Although potential confounding by unmeasured factors cannot be ruled out, our findings lend support to the hypothesis that severe life stressors, such as child loss, may raise the risk for several, chiefly HPV-related, cancers.

Place, publisher, year, edition, pages
Philadelphia, USA: American Association for Cancer Research , 2011. Vol. 71, no 1, 116-22 p.
National Category
Medical and Health Sciences Cancer and Oncology
Identifiers
URN: urn:nbn:se:oru:diva-41448DOI: 10.1158/0008-5472.CAN-10-0470ISI: 000285826800014PubMedID: 21084266Scopus ID: 2-s2.0-78651410129OAI: oai:DiVA.org:oru-41448DiVA: diva2:811703
Available from: 2015-05-12 Created: 2015-01-14 Last updated: 2015-06-25Bibliographically approved

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