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World War II-related post-traumatic stress disorder and breast cancer risk among Israeli women: a case-control study

Published online by Cambridge University Press:  02 December 2013

Neomi Vin-Raviv ,
Rachel Dekel ,
Micha Barchana ,
Shai Linn  and
Lital Keinan-Boker
Neomi Vin-Raviv*
Affiliation:
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA School of Public Health, Faculty of Welfare and Health Sciences, University of Haifa, Haifa, Israel
Rachel Dekel
Affiliation:
Louis and Gabi Weisfeld School of Social Work, Faculty of Social Sciences, Bar-Ilan University, Ramat-Gan, Israel
Micha Barchana
Affiliation:
School of Public Health, Faculty of Welfare and Health Sciences, University of Haifa, Haifa, Israel Israel National Cancer Registry, Ministry of Health, Jerusalem, Israel
Shai Linn
Affiliation:
School of Public Health, Faculty of Welfare and Health Sciences, University of Haifa, Haifa, Israel Rambam Medical Center, Haifa, Israel
Lital Keinan-Boker
Affiliation:
School of Public Health, Faculty of Welfare and Health Sciences, University of Haifa, Haifa, Israel Israel Center for Disease Control, Ministry of Health, Tel Hashomer, Ramat-Gan, Israel
*
Correspondence should be addressed to: Neomi Vin-Raviv, MPH, PhD., Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 729A, New York, NY 10032. Phone: +1-212-342-0184; Fax: +1-212-305-9413. Email: nv2222@columbia.edu.
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Abstract

Background:

Several studies have suggested that post-traumatic stress disorder (PTSD) is related to adverse health outcomes. There are limited data on PTSD and cancer, which has a long latency period. We investigated the association between World War II (WWII)-related PTSD and subsequent breast cancer (BC) risk among Jewish WWII survivors and examined whether this association was modified by exposure to hunger during WWII.

Methods:

We compared 65 BC patients diagnosed in 2005 through 2010 to 200 population-based controls who were members of various organizations for Jewish WWII survivors in Israel. All participants were born in Europe, lived at least six months under Nazi rule during WWII, and immigrated to Israel after the war. We estimated PTSD using the PTSD Inventory and applied logistic regression models to estimate the association between WWII-related PTSD and BC, adjusting for potential confounders.

Results:

We observed a linear association between WWII-related PTSD and BC risk. This association remained significant following adjustment for potential confounders, including obesity, alcohol consumption, smoking, age during WWII, hunger exposure during WWII, and total number of traumatic life events (OR = 2.89, 95% CI = 1.14–7.31). However, the level of hunger exposure during WWII modified this effect significantly.

Conclusions:

These findings suggest an independent association between WWII-related PTSD and subsequent BC risk in Jewish WWII survivors that is modified by hunger, a novel finding. Future research is needed to further explore these findings.

Keywords

breast cancerhungerIsraelJewsPTSDWorld War II
Type
Research Article
Information
International Psychogeriatrics , Volume 26 , Issue 3 , March 2014 , pp. 499 - 508
Copyright
Copyright © International Psychogeriatric Association 2013 

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