Can distress increase your risk of ovarian cancer?

by Rebecca Israel, MS

October 12, 2020

  • Researchers are discovering associations between mental disorders and cancer.

  • Studies suggest that PTSD and depression could be risk factors for ovarian cancer.

  • Mental distress could be considered a risk factor for ovarian cancer in the preventative care process.

Ovarian cancer is a form of cancer that targets the ovaries. This type of cancer is difficult to detect because there is no simple test or screening method. At this point in medicine, those at high risk for ovarian cancer are often advised to remove their ovaries altogether after they are done having children. But before that time, preventative care is most important.

There is no way to know for sure if you will get ovarian cancer. Most women get it without being at high risk. However, several factors may increase a woman’s risk of ovarian cancer.

There is no way to know for sure if you will get ovarian cancer. Most women get it without being at high risk. However, several factors may increase a woman’s risk of ovarian cancer.

Source: CDC What Are the Risk Factors for Ovarian Cancer?

There are many known risk factors for ovarian and other reproductive cancers. As with most cancers, the risk increases with age. A history of cancer and reproductive conditions may also increase your risk. Researchers who study the human genome have identified specific genes linked to ovarian cancer that are passed down in the family. In addition, a long history of birth control use that does not contain progesterone may increase your risk of ovarian cancer. However, most birth controls contain progesterone, and recent studies suggest that these methods are actually protective against reproductive cancers.

Post-traumatic stress disorder

A newer field of study is the relationship between mental health and cancer. Holistic practitioners have long believed that our psychological well-being directly affects our physical well-being. Recent studies have found evidence that supports this belief in regards to ovarian cancer.

Post-traumatic stress disorder (PTSD) is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event. People who have PTSD may feel stressed or frightened, even when they are not in danger.

National Institute of Mental Health
PTSD is associated with ovarian cancer risk, particularly in premenopausal women.

Women with high PTSD symptoms had 2-fold greater risk of ovarian cancer versus women with no trauma exposure [age-adjusted HR = 2.10; 95% confidence interval (CI), 1.12–3.95]. Adjustment for health and ovarian cancer risk factors moderately attenuated this association (HR = 1.86; 95% CI, 0.98–3.51).

Source: Posttraumatic Stress Disorder Is Associated with Increased Risk of Ovarian Cancer: A Prospective and Retrospective Longitudinal Cohort Study

In the initial analysis, women who reported 6 to 7 PTSD symptoms had more than twice the risk of ovarian cancer compared to women with no trauma reported. The link between ovarian cancer and PTSD symptoms was especially prevalent in premenopausal women. After adjusting for other risk factors, the relationship became weaker, though still leaning toward an association.

Adjusting for ovarian cancer risk factors and health behaviors related to PTSD only modestly attenuated the observed association, leaving open the possibility that hormonal, immune or other biological changes following PTSD may increase the risk of ovarian cancer.

Cancer Research

Depression

Depression is a common mental disorder, especially among women. Scientists believe that hormonal changes caused by puberty, pregnancy, or birth control may increase the risk of depression.

Depression negatively affects how you feel, the way you think, and how you act. Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home.

American Psychiatric Association
Depression may be associated with a modestly increased risk of ovarian cancer.

Compared to women with persistent negative depression status, the adjusted HRs were 1.34 (95% CI 1.01-1.76) for women with persistent positive depression status and 1.28 (95% CI 0.88-1.85) for women with worsening depression status over follow-up.

Source: Depression and risk of epithelial ovarian cancer: Results from two large prospective cohort studies

Researchers discovered that women diagnosed with ovarian cancer were more likely to have a persistent depression diagnosis. Women with worsening depressive symptoms did not have as strong of an association with ovarian cancer as women with a persistent diagnosis. This is not entirely surprising, as there is strong evidence that links cancer risk with high rates of stress. Depression also alters behaviors that could result in poor health-related choices.

Final thoughts

Studies have found an association between mental disorders and ovarian cancer. Women with highly symptomatic PTSD may be at higher risk for ovarian cancer. Similarly, women with a persistent depression diagnosis were more likely to develop ovarian cancer than without a depression diagnosis. The relationship between trauma, stress, hormones, and other risk factors is complicated when estimating ovarian cancer risk. Having PTSD or depression does not guarantee a cancer diagnosis, rather, it is one factor of many that could play a role.

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