title: Lifetime report of perceived stress at work and cancer among men: A case-control study in Montreal, Canada.
abstract: BACKGROUND
  The association between perceived workplace psychological stress, over the entire work career, and cancer among men has never been assessed. This was explored in the context of a population-based case-control study conducted in Montreal, Canada.
  
  
  METHODS
  3103 incident cancer cases (11 types) diagnosed in 1979-1985 and 512 population controls were interviewed. Subjects described in detail each job held during their lifetime, including the occurrence of stress, and its reason. Logistic regression estimated odds ratios (OR) and 95% confidence intervals (CI) for the association between perceived workplace stress and its duration, and each cancer site, adjusting for lifestyle and occupational factors.
  
  
  RESULTS
  Employment in at least one stressful job was associated with increased odds of cancers of the lung (OR=1.33, 95% CI: 1.01-1.75), colon (OR=1.51, 95% CI: 1.15-1.98), bladder (OR=1.37, 95% CI: 1.03-1.81), rectal (OR=1.52, 95% CI: 1.10-2.10), and stomach (OR=1.53, 95% CI: 1.08-2.15). A duration-response trend was found for cancers of the lung, colon, rectum, stomach, and for NHL. Subjects reported changes in stress level over their career. Perceived stress was ascribed to several sources, including high demand and time pressure, financial issues, job insecurity, and hazardous conditions.
  
  
  CONCLUSIONS
  Prolonged exposure to perceived stress at work was associated with greater odds of cancer at 5 out of 11 sites. While over reporting of stress by cases cannot be fully ruled out, these associations, if substantiated, would bear important public health significance. Prospective studies building on detailed stress assessment protocols considering all sources and changes over the career are necessary.
authors.affiliation: Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Institut national de la recherche scientifique (INRS), University of Quebec, 531 Boulevard des Prairies, Laval, QC H7V 1B7, Canada.
authors.forename: Audrey
authors.initials: A
authors.lastname: Blanc-Lapierre
authors.affiliation: Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Institut national de la recherche scientifique (INRS), University of Quebec, 531 Boulevard des Prairies, Laval, QC H7V 1B7, Canada; School of Public Health, Department of Social and Preventive Medicine, University of Montreal, 7101 Avenue du Parc, Montreal, QC H3N 1X9, Canada; University of Montreal Hospital Research Center (CRCHUM), Tour Saint-Antoine, 850 St. Denis Street, Montreal, QC H2X 0A9, Canada.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Rousseau
authors.affiliation: Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Institut national de la recherche scientifique (INRS), University of Quebec, 531 Boulevard des Prairies, Laval, QC H7V 1B7, Canada.
authors.forename: Deborah
authors.initials: D
authors.lastname: Weiss
authors.affiliation: Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Institut national de la recherche scientifique (INRS), University of Quebec, 531 Boulevard des Prairies, Laval, QC H7V 1B7, Canada.
authors.forename: Mariam
authors.initials: M
authors.lastname: El-Zein
authors.affiliation: School of Public Health, Department of Social and Preventive Medicine, University of Montreal, 7101 Avenue du Parc, Montreal, QC H3N 1X9, Canada; University of Montreal Hospital Research Center (CRCHUM), Tour Saint-Antoine, 850 St. Denis Street, Montreal, QC H2X 0A9, Canada.
authors.forename: Jack
authors.initials: J
authors.lastname: Siemiatycki
authors.affiliation: Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Institut national de la recherche scientifique (INRS), University of Quebec, 531 Boulevard des Prairies, Laval, QC H7V 1B7, Canada; School of Public Health, Department of Social and Preventive Medicine, University of Montreal, 7101 Avenue du Parc, Montreal, QC H3N 1X9, Canada; University of Montreal Hospital Research Center (CRCHUM), Tour Saint-Antoine, 850 St. Denis Street, Montreal, QC H2X 0A9, Canada. Electronic address: marie-elise.parent@iaf.inrs.ca.
authors.forename: Marie-Élise
authors.initials: MÉ
authors.lastname: Parent
mesh_terms: D002170:Canada / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009790:Occupations; D012189:Retrospective Studies; D012307:Risk Factors; D013315:Stress, Psychological / Q000523:psychology*; D013997:Time Factors; D017132:Workplace / Q000523:psychology*
keywords: Cancer; Case-control; Lifetime; Men; Self-report; Workplace stress