Cancer incidence and survival following bereavement.
OBJECTIVE
This study investigated the effect of parental bereavement on cancer incidence and survival.


METHODS
A cohort of 6284 Jewish Israelis who lost an adult son in the Yom Kippur War or in an accident between 1970 and 1977 was followed for 20 years. We compared the incidence of cancer in this cohort with that among nonbereaved members of the population by logistic regression analysis. The survival of bereaved parents with cancer was compared with that of matched controls with cancer.


RESULTS
Increased incidence was found for lymphatic and hematopoietic malignancies among the parents of accident victims (odds ratio [OR] = 2.01; 95% confidence interval [CI] = 1.30, 3.11) and among war-bereaved parents (OR = 1.47; 95% CI = 1.13, 1.92), as well as for melanomas (OR = 4.62 [95% CI = 1.93, 11.06] and 1.71 [95% CI = 1.06, 2.76], respectively). Accident-bereaved parents also had an increased risk of respiratory cancer (OR = 1.50; 95% CI = 1.07, 2.11). The survival study showed that the risk of death was increased by bereavement if the cancer had been diagnosed before the loss, but not after.


CONCLUSIONS
This study showed an effect of stress on the incidence of malignancies for selected sites and accelerated demise among parents bereaved following a diagnosis of cancer, but not among those bereaved before such a diagnosis.
Levav
I
I
Pan American Health Organization/World Health Organization, Washington, DC, USA. itzhak.levav@moh.health.gov.il
Kohn
R
R
Iscovich
J
J
Abramson
J H
JH
Tsai
W Y
WY
Vigdorovich
D
D
D000059:Accidents; D000293:Adolescent; D000328:Adult; D001601:Bereavement; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D010290:Parents / Q000523:psychology*; D016016:Proportional Hazards Models; D012306:Risk; D016019:Survival Analysis; D014857:Warfare