Psychosocial factors and the risk of cancer: An individual-participant data meta-analysis

Lonneke A van Tuijl; Kuan-Yu Pan; Maartje Basten; Roel Vermeulen; Lützen Portengen; Alexander de Graeff; Joost Dekker; Mirjam I Geerlings; Adriaan W Hoogendoorn; Femke Lamers; Adri C Voogd; Jessica Abell; Philip Awadalla; Aartjan T F Beekman; Ottar Bjerkeset; Andy Boyd; Yunsong Cui; Philipp Frank; Henrike Galenkamp; Bert Garssen; Sean Hellingman; Martijn Huisman; Anke Huss; Trynke R de Jong; Melanie R Keats; Almar A L Kok; Steinar Krokstad; Flora E van Leeuwen; Annemarie I Luik; Nolwenn Noisel; Yves Payette; Brenda W J H Penninx; Ina Rissanen; Annelieke M Roest; Rikje Ruiter; Robert A Schoevers; David Soave; Mandy Spaan; Andrew Steptoe; Karien Stronks; Erik R Sund; Ellen Sweeney; Emma L Twait; Alison Teyhan; W M Monique Verschuren; Kimberly D van der Willik; Judith G M Rosmalen; Adelita V Ranchor

doi:10.1002/cncr.70271

Psychosocial factors and the risk of cancer: An individual-participant data meta-analysis

Lonneke A van Tuijl^*
, Kuan-Yu Pan
, Maartje Basten
, Roel Vermeulen
, Lützen Portengen
, Alexander de Graeff
, Joost Dekker
, Mirjam I Geerlings
, Adriaan W Hoogendoorn
, Femke Lamers
, Adri C Voogd
, Jessica Abell
, Philip Awadalla
, Aartjan T F Beekman
, Ottar Bjerkeset
, Andy Boyd
, Yunsong Cui
, Philipp Frank
, Henrike Galenkamp
, Bert Garssen

Sean Hellingman, Martijn Huisman, Anke Huss, Trynke R de Jong, Melanie R Keats, Almar A L Kok, Steinar Krokstad, Flora E van Leeuwen, Annemarie I Luik, Nolwenn Noisel, Yves Payette, Brenda W J H Penninx, Ina Rissanen, Annelieke M Roest, Rikje Ruiter, Robert A Schoevers, David Soave, Mandy Spaan, Andrew Steptoe, Karien Stronks, Erik R Sund, Ellen Sweeney, Emma L Twait, Alison Teyhan, W M Monique Verschuren, Kimberly D van der Willik, Judith G M Rosmalen, Adelita V Ranchor

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

BACKGROUND: Psychosocial factors are argued to increase cancer risk. This study aims to clarify the association between various psychosocial factors and cancer incidence (including breast, lung, prostate, and colorectal cancers) via individual-participant data (IPD) meta-analysis. The psychosocial factors considered were perceived social support (PSS), loss, relationship status, neuroticism, and general distress.

METHODS: The Psychosocial Factors and Cancer Incidence consortium used data from 22 cohorts with a measure of at least one psychosocial variable of interest at baseline (up to N = 421,799; cancer incidence, N = 35,319; person-years of follow-up, N = 4,378,582). In stage 1 of the IPD meta-analysis, Cox regression models were used with age as the timescale. In stage 2, results were pooled in random-effects meta-analyses.

RESULTS: No psychosocial factors were associated with an increased risk of overall cancer and with breast, prostate, and colorectal cancers, as well as with cancers with alcohol as a common potential causal factor. PSS, currently not in a relationship, and a loss event were associated with an increased risk of lung cancer (hazard ratio [HR], 1.09-1.55). Estimates decreased for PSS and relationship status when adjusting for several known risk factors, such as a family history of cancer (HR, 1.05-1.08). Similar findings were observed for relationship status and cancers with tobacco smoking as a common potential causal factor.

CONCLUSIONS: For most types of cancer, psychosocial factors (measured at a single point in time) were not associated with increased risk. PSS, currently not in a relationship, and loss were associated with an increased risk of lung cancer, although most effects attenuated when adjusting for several known risk factors.

Original language	English
Article number	e70271
Journal	Cancer
Volume	132
Issue number	7
DOIs	https://doi.org/10.1002/cncr.70271
Publication status	Published - 1 Apr 2026

Keywords

cancer incidence
loss
neuroticism
prospective
relationship
social support
stress

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Cancer - 2026 - Tuijl - Psychosocial factors and the risk of cancer An individual‐participant data meta‐analysisFinal published version, 570 KBLicence: CC BY-NC

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van Tuijl, L. A., Pan, K.-Y., Basten, M., Vermeulen, R., Portengen, L., de Graeff, A., Dekker, J., Geerlings, M. I., Hoogendoorn, A. W., Lamers, F., Voogd, A. C., Abell, J., Awadalla, P., Beekman, A. T. F., Bjerkeset, O., Boyd, A., Cui, Y., Frank, P., Galenkamp, H., ... Ranchor, A. V. (2026). Psychosocial factors and the risk of cancer: An individual-participant data meta-analysis. Cancer, 132(7), Article e70271. https://doi.org/10.1002/cncr.70271

@article{6837cab7fc364bcf9c3ee73720b19529,

title = "Psychosocial factors and the risk of cancer: An individual-participant data meta-analysis",

abstract = "BACKGROUND: Psychosocial factors are argued to increase cancer risk. This study aims to clarify the association between various psychosocial factors and cancer incidence (including breast, lung, prostate, and colorectal cancers) via individual-participant data (IPD) meta-analysis. The psychosocial factors considered were perceived social support (PSS), loss, relationship status, neuroticism, and general distress.METHODS: The Psychosocial Factors and Cancer Incidence consortium used data from 22 cohorts with a measure of at least one psychosocial variable of interest at baseline (up to N = 421,799; cancer incidence, N = 35,319; person-years of follow-up, N = 4,378,582). In stage 1 of the IPD meta-analysis, Cox regression models were used with age as the timescale. In stage 2, results were pooled in random-effects meta-analyses.RESULTS: No psychosocial factors were associated with an increased risk of overall cancer and with breast, prostate, and colorectal cancers, as well as with cancers with alcohol as a common potential causal factor. PSS, currently not in a relationship, and a loss event were associated with an increased risk of lung cancer (hazard ratio [HR], 1.09-1.55). Estimates decreased for PSS and relationship status when adjusting for several known risk factors, such as a family history of cancer (HR, 1.05-1.08). Similar findings were observed for relationship status and cancers with tobacco smoking as a common potential causal factor.CONCLUSIONS: For most types of cancer, psychosocial factors (measured at a single point in time) were not associated with increased risk. PSS, currently not in a relationship, and loss were associated with an increased risk of lung cancer, although most effects attenuated when adjusting for several known risk factors.",

keywords = "cancer incidence, loss, neuroticism, prospective, relationship, social support, stress",

author = "\{van Tuijl\}, \{Lonneke A\} and Kuan-Yu Pan and Maartje Basten and Roel Vermeulen and L{\"u}tzen Portengen and \{de Graeff\}, Alexander and Joost Dekker and Geerlings, \{Mirjam I\} and Hoogendoorn, \{Adriaan W\} and Femke Lamers and Voogd, \{Adri C\} and Jessica Abell and Philip Awadalla and Beekman, \{Aartjan T F\} and Ottar Bjerkeset and Andy Boyd and Yunsong Cui and Philipp Frank and Henrike Galenkamp and Bert Garssen and Sean Hellingman and Martijn Huisman and Anke Huss and \{de Jong\}, \{Trynke R\} and Keats, \{Melanie R\} and Kok, \{Almar A L\} and Steinar Krokstad and \{van Leeuwen\}, \{Flora E\} and Luik, \{Annemarie I\} and Nolwenn Noisel and Yves Payette and Penninx, \{Brenda W J H\} and Ina Rissanen and Roest, \{Annelieke M\} and Rikje Ruiter and Schoevers, \{Robert A\} and David Soave and Mandy Spaan and Andrew Steptoe and Karien Stronks and Sund, \{Erik R\} and Ellen Sweeney and Twait, \{Emma L\} and Alison Teyhan and Verschuren, \{W M Monique\} and \{van der Willik\}, \{Kimberly D\} and Rosmalen, \{Judith G M\} and Ranchor, \{Adelita V\}",

note = "Publisher Copyright: {\textcopyright} 2026 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.",

year = "2026",

month = apr,

day = "1",

doi = "10.1002/cncr.70271",

language = "English",

volume = "132",

journal = "Cancer",

issn = "0008-543X",

publisher = "John Wiley \& Sons Inc.",

number = "7",

}

van Tuijl, LA, Pan, K-Y, Basten, M, Vermeulen, R, Portengen, L, de Graeff, A, Dekker, J, Geerlings, MI, Hoogendoorn, AW, Lamers, F, Voogd, AC, Abell, J, Awadalla, P, Beekman, ATF, Bjerkeset, O, Boyd, A, Cui, Y, Frank, P, Galenkamp, H, Garssen, B, Hellingman, S, Huisman, M, Huss, A, de Jong, TR, Keats, MR, Kok, AAL, Krokstad, S, van Leeuwen, FE, Luik, AI, Noisel, N, Payette, Y, Penninx, BWJH, Rissanen, I, Roest, AM, Ruiter, R, Schoevers, RA, Soave, D, Spaan, M, Steptoe, A, Stronks, K, Sund, ER, Sweeney, E, Twait, EL, Teyhan, A, Verschuren, WMM, van der Willik, KD, Rosmalen, JGM & Ranchor, AV 2026, 'Psychosocial factors and the risk of cancer: An individual-participant data meta-analysis', Cancer, vol. 132, no. 7, e70271. https://doi.org/10.1002/cncr.70271

TY - JOUR

T1 - Psychosocial factors and the risk of cancer

T2 - An individual-participant data meta-analysis

AU - van Tuijl, Lonneke A

AU - Pan, Kuan-Yu

AU - Basten, Maartje

AU - Vermeulen, Roel

AU - Portengen, Lützen

AU - de Graeff, Alexander

AU - Dekker, Joost

AU - Geerlings, Mirjam I

AU - Hoogendoorn, Adriaan W

AU - Lamers, Femke

AU - Voogd, Adri C

AU - Abell, Jessica

AU - Awadalla, Philip

AU - Beekman, Aartjan T F

AU - Bjerkeset, Ottar

AU - Boyd, Andy

AU - Cui, Yunsong

AU - Frank, Philipp

AU - Galenkamp, Henrike

AU - Garssen, Bert

AU - Hellingman, Sean

AU - Huisman, Martijn

AU - Huss, Anke

AU - de Jong, Trynke R

AU - Keats, Melanie R

AU - Kok, Almar A L

AU - Krokstad, Steinar

AU - van Leeuwen, Flora E

AU - Luik, Annemarie I

AU - Noisel, Nolwenn

AU - Payette, Yves

AU - Penninx, Brenda W J H

AU - Rissanen, Ina

AU - Roest, Annelieke M

AU - Ruiter, Rikje

AU - Schoevers, Robert A

AU - Soave, David

AU - Spaan, Mandy

AU - Steptoe, Andrew

AU - Stronks, Karien

AU - Sund, Erik R

AU - Sweeney, Ellen

AU - Twait, Emma L

AU - Teyhan, Alison

AU - Verschuren, W M Monique

AU - van der Willik, Kimberly D

AU - Rosmalen, Judith G M

AU - Ranchor, Adelita V

PY - 2026/4/1

Y1 - 2026/4/1

N2 - BACKGROUND: Psychosocial factors are argued to increase cancer risk. This study aims to clarify the association between various psychosocial factors and cancer incidence (including breast, lung, prostate, and colorectal cancers) via individual-participant data (IPD) meta-analysis. The psychosocial factors considered were perceived social support (PSS), loss, relationship status, neuroticism, and general distress.METHODS: The Psychosocial Factors and Cancer Incidence consortium used data from 22 cohorts with a measure of at least one psychosocial variable of interest at baseline (up to N = 421,799; cancer incidence, N = 35,319; person-years of follow-up, N = 4,378,582). In stage 1 of the IPD meta-analysis, Cox regression models were used with age as the timescale. In stage 2, results were pooled in random-effects meta-analyses.RESULTS: No psychosocial factors were associated with an increased risk of overall cancer and with breast, prostate, and colorectal cancers, as well as with cancers with alcohol as a common potential causal factor. PSS, currently not in a relationship, and a loss event were associated with an increased risk of lung cancer (hazard ratio [HR], 1.09-1.55). Estimates decreased for PSS and relationship status when adjusting for several known risk factors, such as a family history of cancer (HR, 1.05-1.08). Similar findings were observed for relationship status and cancers with tobacco smoking as a common potential causal factor.CONCLUSIONS: For most types of cancer, psychosocial factors (measured at a single point in time) were not associated with increased risk. PSS, currently not in a relationship, and loss were associated with an increased risk of lung cancer, although most effects attenuated when adjusting for several known risk factors.

AB - BACKGROUND: Psychosocial factors are argued to increase cancer risk. This study aims to clarify the association between various psychosocial factors and cancer incidence (including breast, lung, prostate, and colorectal cancers) via individual-participant data (IPD) meta-analysis. The psychosocial factors considered were perceived social support (PSS), loss, relationship status, neuroticism, and general distress.METHODS: The Psychosocial Factors and Cancer Incidence consortium used data from 22 cohorts with a measure of at least one psychosocial variable of interest at baseline (up to N = 421,799; cancer incidence, N = 35,319; person-years of follow-up, N = 4,378,582). In stage 1 of the IPD meta-analysis, Cox regression models were used with age as the timescale. In stage 2, results were pooled in random-effects meta-analyses.RESULTS: No psychosocial factors were associated with an increased risk of overall cancer and with breast, prostate, and colorectal cancers, as well as with cancers with alcohol as a common potential causal factor. PSS, currently not in a relationship, and a loss event were associated with an increased risk of lung cancer (hazard ratio [HR], 1.09-1.55). Estimates decreased for PSS and relationship status when adjusting for several known risk factors, such as a family history of cancer (HR, 1.05-1.08). Similar findings were observed for relationship status and cancers with tobacco smoking as a common potential causal factor.CONCLUSIONS: For most types of cancer, psychosocial factors (measured at a single point in time) were not associated with increased risk. PSS, currently not in a relationship, and loss were associated with an increased risk of lung cancer, although most effects attenuated when adjusting for several known risk factors.

KW - cancer incidence

KW - loss

KW - neuroticism

KW - prospective

KW - relationship

KW - social support

KW - stress

UR - https://www.scopus.com/pages/publications/105033601457

U2 - 10.1002/cncr.70271

DO - 10.1002/cncr.70271

M3 - Article

C2 - 41866892

SN - 0008-543X

VL - 132

JO - Cancer

JF - Cancer

IS - 7

M1 - e70271

ER -

Psychosocial factors and the risk of cancer: An individual-participant data meta-analysis

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