Cancer
Associations between Posttraumatic Stress Disorder and Cancer Prevalence in a Cohort of Vietnam-Era Women Veterans Hannah M. Burns* Hannah Burns Kelsey N. Serier Kathryn M. Magruder Rachel Kimerling Avron Spiro Anica Pless Kaiser Brian N. Smith
The role of Posttraumatic Stress Disorder (PTSD) as a risk factor for various cancers is unclear, with mixed results in the extant literature. One study found that PTSD was a risk factor for ovarian cancer, but other studies have found no such association with ovarian and other cancers (e.g., breast and lung); however, evidence is sparse, including no studies to date focused on women Veterans.
Utilizing data from a cohort of Vietnam-era women Veterans (N=4219, Mage=67), weighted logistic regression analyses were conducted to examine the association between PTSD and likelihood of reproductive (cervical, uterine, ovarian), breast, lung, and colon cancers. Lifetime PTSD was assessed by phone interview with the Composite International Diagnostic Interview, while cancer diagnoses were self-reported. Analyses excluded cases with missing PTSD/cancer diagnoses, age of onset, or a cancer diagnosis preceding PTSD.
The prevalence of reproductive, breast, lung, and colon cancers were 6.4%, 8.6%, 0.4%, and 1.1% in Veterans with lifetime PTSD, and 4.6%, 11.0%, 0.8%, and 1.8% in Veterans without PTSD. PTSD was not associated with increased odds of reproductive (OR= 1.42 [95% CI 0.94; 2.14]), breast (OR= 0.80 [95% CI 0.57; 1.11]), lung (OR= 0.58 [95% CI 0.13; 2.66]), or colon (OR= 0.64 [95% CI 0.25; 1.61]) cancer when adjusting for demographics, military characteristics, and health behaviors. Unadjusted models also yielded nonsignificant results.
PTSD was not associated with cancers examined in this study of women Veterans. These findings are consistent with other studies investigating PTSD with breast and lung cancer but are inconsistent with some previous findings on PTSD and ovarian cancer. We may not have observed an association between PTSD and reproductive cancer in part due to the sample size, survival bias, and retrospective cross-sectional nature of the data. Prospective research would help determine if PTSD is an important consideration for cancer risk in women Veterans.
