According to experts, the wear and tear on the body due to chronic and lifelong stress can increase the risk of cancer mortality. That wear and tear, called allostatic load, refers to the cumulative effects of stress over time. Justin Xavier Moore, MD, an epidemiologist at the Medical College of Georgia and Georgia, said, “As a response to external stressors, your body releases a stress hormone called cortisol, and then once the stress is over, these levels increase. Must go back down.” Cancer Center. “However, if you have chronic, ongoing psychosocial stressors that never allow you to ‘get down,’ it can cause wear and tear on your body on a biological level.”
The investigators, led by Moore, retrospectively analyzed more than 41,000 people from the National Health and Nutrition Examination Survey, or NHANES, collected between 1988-2019. That database includes participants’ baseline biological measures – body mass index, diastolic and systolic blood pressure, total cholesterol, hemoglobin A1C (high levels indicate risk for diabetes), albumin and creatinine (both measures of kidney function). , and C-reactive protein (a measure of inflammation)—which the researchers used to determine allostatic load. Those with a score greater than 3 were classified as those with a high allostatic load. They then cross-referenced those participants with the National Death Index, maintained by the National Center for Health Statistics and the Centers for Disease Control and Prevention, to determine which people died of cancer and when, said Moore. explained.
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“To date, there has been limited research on the relationship between allostatic load and cancer among a current, nationally representative sample of US adults,” Moore and colleagues write in the journal SSM Population Health. “Examining the relationship of allostatic load on cancer outcomes, and whether these associations differ by race, may give insight into novel approaches in reducing cancer disparities.” The researchers found that, without adjusting for any potential confounders such as age, social demographics such as race and gender, poverty-to-income ratio and educational level, people with a high allostatic load were 2.4 times more likely to die of cancer than those with a low allostatic load. Were heavy. “But you have to adjust for confounding factors,” explains Moore. “We know there are differences in allocation weights based on age, caste and gender.”
In fact, in previous research, he and his colleagues observed that when looking at trends in allostatic load over 30 years among 50,671 individuals, adults 40 years of age and older had higher allostatic load than adults younger than 30. The risk of load was greater than 100%. Furthermore, regardless of time period, black and Latino adults had an increased risk of high allostatic load compared with their white counterparts. Much of that, says Moore, can be attributed to structural racism — things like better educational opportunities or difficulty navigating a fair and equitable home loan. “If you were born in an environment where your opportunities are very different from your white male counterparts, for example being a black woman, your life path involves dealing with more adversities,” he said.
Even when controlling for age, the researchers found that those with a higher allostatic load still had a 28% increased risk of dying from cancer. “That means if you have two people of the same age and if one of them has a high allostatic load, your chances of dying from cancer are 28% higher,” says Moore. Adjusting for sociodemographic factors, including gender and race and educational level, the higher allocation load increased by 21%; And further adjusting the model for other risk factors such as whether participants had smoked, had a prior heart attack, or had been previously diagnosed with cancer or congestive heart failure, led to a 14% increase.
Moore and colleagues specifically examined the relationship between allostatic load and cancer mortality among each racial/ethnic group (for example, non-Hispanic Blacks, non-Hispanic whites, and Hispanic adults). However, allostatic load was not as strongly related when divided by race categories. These findings can be explained by the sheer size of the original sample. “Epidemiologically, when 41,000 people are looked at, there are a number of cancer-related deaths,” Moore explains. “However, when you have essentially fewer data points to measure, it is more difficult to detect the relationship between x (allostatic load) and y (death from cancer).” For example, limiting the sample to only non-Hispanic blacks would mean analyzing a sample of only 11,000 people, so the relationship may appear low or weak. “The reason race even matters is because there are systemic factors that disproportionately affect people of color,” he said. “But if you drop out of the race, the bottom line is the environment in which we live, work and play, where you are rewarded for doing more and sometimes taking time for yourself.” This is seen as vulnerable to high stress, which in turn can lead to cancer development and increased morbidity and mortality.” In the United States, cancer is the second leading cause of death and was responsible for an estimated 1.9 million cases and approximately 609,000 deaths in 2021.
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