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

Maartje Basten; Kuan Yu Pan; Lonneke A. van Tuijl; Alexander de Graeff; Joost Dekker; Adriaan W. Hoogendoorn; Femke Lamers; Adelita V. Ranchor; Roel Vermeulen; Lützen Portengen; Adri C. Voogd; Jessica Abell; Philip Awadalla; Aartjan T.F. Beekman; Ottar Bjerkeset; Andy Boyd; Yunsong Cui; Philipp Frank; Henrike Galenkamp; Bert Garssen; Sean Hellingman; Martijn Huisman; Anke Huss; Melanie R. Keats; Almar A.L. Kok; Steinar Krokstad; Flora E. van Leeuwen; Annemarie I. Luik; Nolwenn Noisel; Yves Payette; Brenda W.J.H. Penninx; Ina Rissanen; Annelieke M. Roest; Judith G.M. Rosmalen; Rikje Ruiter; Robert A. Schoevers; David Soave; Mandy Spaan; Andrew Steptoe; Karien Stronks; Erik R. Sund; Ellen Sweeney; Emma L. Twait; Alison Teyhan; W. M.Monique Verschuren; Kimberly D. van der Willik; Mirjam I. Geerlings

doi:10.1002/ijc.34852

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

Maartje Basten^*
, Kuan Yu Pan
, Lonneke A. van Tuijl
, Alexander de Graeff
, Joost Dekker
, Adriaan W. Hoogendoorn
, Femke Lamers
, Adelita V. Ranchor
, Roel Vermeulen
, Lützen Portengen
, Adri C. Voogd
, Jessica Abell
, Philip Awadalla
, Aartjan T.F. Beekman
, Ottar Bjerkeset
, Andy Boyd
, Yunsong Cui
, Philipp Frank
, Henrike Galenkamp
, Bert Garssen

Sean Hellingman, Martijn Huisman, Anke Huss, Melanie R. Keats, Almar A.L. Kok, Steinar Krokstad, Flora E. van Leeuwen, Annemarie I. Luik, Nolwenn Noisel, Yves Payette, Brenda W.J.H. Penninx, Ina Rissanen, Annelieke M. Roest, Judith G.M. Rosmalen, Rikje Ruiter, Robert A. Schoevers, David Soave, Mandy Spaan, Andrew Steptoe, Karien Stronks, Erik R. Sund, Ellen Sweeney, Emma L. Twait, Alison Teyhan, W. M.Monique Verschuren, Kimberly D. van der Willik, Mirjam I. Geerlings

^*Corresponding author for this work

Epidemiology

Amsterdam Public Health Research Institute
Vrije Universiteit Amsterdam
Karolinska Institutet
University Medical Centre Groningen
Utrecht University
Maastricht University
Netherlands Comprehensive Cancer Organization (IKNL)
University College London
Ontario Institute for Cancer Research
University of Toronto
Nord University
Norwegian University of Science and Technology
University of Bristol
Dalhousie University
University of Amsterdam
Wilfrid Laurier University
Nord-Trøndelag Hospital Trust
Netherlands Cancer Institute
CHU Sainte-Justine Research Center
University of Groningen
National Institute of Public Health and the Environment
Amsterdam UMC
University Medical Centre Utrecht
Maasstad Hospital

Research output: Contribution to journal › Article › Academic › peer-review

20 Citations (Scopus)

125 Downloads (Pure)

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.

Original language	English
Pages (from-to)	1745-1759
Number of pages	15
Journal	International Journal of Cancer
Volume	154
Issue number	10
Early online date	30 Jan 2024
DOIs	https://doi.org/10.1002/ijc.34852
Publication status	Published - 15 May 2024

Bibliographical note

Publisher Copyright:
© 2024 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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Psychosocial factors, health behaviors and risk of cancer incidenceFinal published version, 24.6 MBLicence: CC BY

Cite this

Basten, M., Pan, K. Y., van Tuijl, L. A., de Graeff, A., Dekker, J., Hoogendoorn, A. W., Lamers, F., Ranchor, A. V., Vermeulen, R., Portengen, L., Voogd, A. C., Abell, J., Awadalla, P., Beekman, A. T. F., Bjerkeset, O., Boyd, A., Cui, Y., Frank, P., Galenkamp, H., ... Geerlings, M. I. (2024). Psychosocial factors, health behaviors and risk of cancer incidence: Testing interaction and effect modification in an individual participant data meta-analysis. International Journal of Cancer, 154(10), 1745-1759. https://doi.org/10.1002/ijc.34852

@article{42c59271d12c43ce8b6d709c037a9191,

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

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.",

author = "Maartje Basten and Pan, \{Kuan Yu\} and \{van Tuijl\}, \{Lonneke A.\} and \{de Graeff\}, Alexander and Joost Dekker and Hoogendoorn, \{Adriaan W.\} and Femke Lamers and Ranchor, \{Adelita V.\} and Roel Vermeulen and L{\"u}tzen Portengen and Voogd, \{Adri C.\} and Jessica Abell and Philip Awadalla and Beekman, \{Aartjan T.F.\} and Ottar Bjerkeset and Andy Boyd and Yunsong Cui and Philipp Frank and Henrike Galenkamp and Bert Garssen and Sean Hellingman and Martijn Huisman and Anke Huss and Keats, \{Melanie R.\} and Kok, \{Almar A.L.\} and Steinar Krokstad and \{van Leeuwen\}, \{Flora E.\} and Luik, \{Annemarie I.\} and Nolwenn Noisel and Yves Payette and Penninx, \{Brenda W.J.H.\} and Ina Rissanen and Roest, \{Annelieke M.\} and Rosmalen, \{Judith G.M.\} and Rikje Ruiter and Schoevers, \{Robert A.\} and David Soave and Mandy Spaan and Andrew Steptoe and Karien Stronks and Sund, \{Erik R.\} and Ellen Sweeney and Twait, \{Emma L.\} and Alison Teyhan and Verschuren, \{W. M.Monique\} and \{van der Willik\}, \{Kimberly D.\} and Geerlings, \{Mirjam I.\}",

note = "Publisher Copyright: {\textcopyright} 2024 The Authors. International Journal of Cancer published by John Wiley \& Sons Ltd on behalf of UICC.",

year = "2024",

month = may,

day = "15",

doi = "10.1002/ijc.34852",

language = "English",

volume = "154",

pages = "1745--1759",

journal = "International Journal of Cancer",

issn = "0020-7136",

publisher = "John Wiley \& Sons Inc.",

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Basten, M, Pan, KY, van Tuijl, LA, de Graeff, A, Dekker, J, Hoogendoorn, AW, Lamers, F, Ranchor, AV, Vermeulen, R, Portengen, L, Voogd, AC, Abell, J, Awadalla, P, Beekman, ATF, Bjerkeset, O, Boyd, A, Cui, Y, Frank, P, Galenkamp, H, Garssen, B, Hellingman, S, Huisman, M, Huss, A, Keats, MR, Kok, AAL, Krokstad, S, van Leeuwen, FE, Luik, AI, Noisel, N, Payette, Y, Penninx, BWJH, Rissanen, I, Roest, AM, Rosmalen, JGM, Ruiter, R, Schoevers, RA, Soave, D, Spaan, M, Steptoe, A, Stronks, K, Sund, ER, Sweeney, E, Twait, EL, Teyhan, A, Verschuren, WMM, van der Willik, KD & Geerlings, MI 2024, 'Psychosocial factors, health behaviors and risk of cancer incidence: Testing interaction and effect modification in an individual participant data meta-analysis', International Journal of Cancer, vol. 154, no. 10, pp. 1745-1759. https://doi.org/10.1002/ijc.34852

Psychosocial factors, health behaviors and risk of cancer incidence: Testing interaction and effect modification in an individual participant data meta-analysis. / Basten, Maartje; Pan, Kuan Yu; van Tuijl, Lonneke A. et al.
In: International Journal of Cancer, Vol. 154, No. 10, 15.05.2024, p. 1745-1759.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Psychosocial factors, health behaviors and risk of cancer incidence

T2 - Testing interaction and effect modification in an individual participant data meta-analysis

AU - Basten, Maartje

AU - Pan, Kuan Yu

AU - van Tuijl, Lonneke A.

AU - de Graeff, Alexander

AU - Dekker, Joost

AU - Hoogendoorn, Adriaan W.

AU - Lamers, Femke

AU - Ranchor, Adelita V.

AU - Vermeulen, Roel

AU - Portengen, Lützen

AU - Voogd, Adri C.

AU - Abell, Jessica

AU - Awadalla, Philip

AU - Beekman, Aartjan T.F.

AU - Bjerkeset, Ottar

AU - Boyd, Andy

AU - Cui, Yunsong

AU - Frank, Philipp

AU - Galenkamp, Henrike

AU - Garssen, Bert

AU - Hellingman, Sean

AU - Huisman, Martijn

AU - Huss, Anke

AU - Keats, Melanie R.

AU - Kok, Almar A.L.

AU - Krokstad, Steinar

AU - van Leeuwen, Flora E.

AU - Luik, Annemarie I.

AU - Noisel, Nolwenn

AU - Payette, Yves

AU - Penninx, Brenda W.J.H.

AU - Rissanen, Ina

AU - Roest, Annelieke M.

AU - Rosmalen, Judith G.M.

AU - Ruiter, Rikje

AU - Schoevers, Robert A.

AU - Soave, David

AU - Spaan, Mandy

AU - Steptoe, Andrew

AU - Stronks, Karien

AU - Sund, Erik R.

AU - Sweeney, Ellen

AU - Twait, Emma L.

AU - Teyhan, Alison

AU - Verschuren, W. M.Monique

AU - van der Willik, Kimberly D.

AU - Geerlings, Mirjam I.

PY - 2024/5/15

Y1 - 2024/5/15

N2 - 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.

AB - 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.

UR - https://www.scopus.com/pages/publications/85183901589

U2 - 10.1002/ijc.34852

DO - 10.1002/ijc.34852

M3 - Article

C2 - 38289012

AN - SCOPUS:85183901589

SN - 0020-7136

VL - 154

SP - 1745

EP - 1759

JO - International Journal of Cancer

JF - International Journal of Cancer

IS - 10

ER -

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

Abstract

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