Abstract：
Psychosocial stress may increase ovarian cancer risk and accelerate disease progression. We examined the association between caregiver burden, a common stressor, and risk of epithelial ovarian cancer. We prospectively followed 67,724 women in the Nurses\' Health Study (NHS; 1992-2012) and 70,720 women in the NHSII (2001-2009) who answered questions on informal caregiving (i.e., caregiving outside of work). Women who reported no informal caregiving were considered non-caregivers while, among women who provided care outside of work, caregiver burden was categorized by time spent caregiving and perceived stress from caregiving. For the 34% of women who provided informal care for ≥15 hours per week, 42% described caregiving as moderately to extremely stressful. Pooled multivariate analyses indicated no difference in ovarian cancer risk for women providing ≥15 hours of care per week compared to non-caregivers (hazard ratio (HR)=0.96; 95% confidence interval (CI): 0.79-1.18), and no association was evident for women who reported moderate or extreme stress from caregiving compared to non-caregivers (HR=0.96; 95% CI: 0.75-1.22). Together with prior work evaluating job strain and ovarian cancer risk, our findings suggest that, when evaluating a stressor\'s role in cancer risk, it is critical to consider how the stressor contributes to the overall experience of distress.
摘要：
心理社会压力可能会增加卵巢癌的风险并加速疾病进展。我们检查了照顾者负担之间的关系，一个常见的压力源，和上皮性卵巢癌的风险。我们前瞻性地跟踪了护士健康研究（NHS；1992-2012）中的67,724名妇女和NHSII（2001-2009）中的70,720名妇女，他们回答了有关非正式护理的问题（即，工作之外的照顾)。报告没有非正式护理的妇女被视为非护理人员，在工作之外提供护理的妇女中，护理人员负担按护理时间和护理压力进行分类.对于34％的每周提供≥15小时非正式护理的妇女，42％的人将护理描述为中度至极度压力。汇总多变量分析表明，与非护理人员相比，每周提供≥15小时护理的女性的卵巢癌风险没有差异（风险比（HR）=0.96；95％置信区间（CI）：0.79-1.18），与非护理人员相比,报告因护理而产生中度或极端压力的女性无明显关联(HR=0.96;95%CI:0.75~1.22).加上先前的工作评估工作压力和卵巢癌风险，我们的研究结果表明，当评估压力源在癌症风险中的作用时，至关重要的是要考虑压力源如何有助于整体的痛苦经历。
