Skip to main content

Advertisement

SpringerLink
Log in

Psychological attitudes and risk of breast cancer in Japan: a prospective study

  • Original Paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Objective

To examine the association between psychological factors and the risk of breast cancer prospectively in a non-Western population.

Methods

Data from the Japan Collaborative Cohort (JACC) study were analyzed. From 1988 to 1990, 34,497 women aged 40–79 years completed a questionnaire on medical, lifestyle and psychosocial factors. The rate ratios (RRs) of their responses were computed by fitting to proportional hazards models.

Results

During the mean follow-up period of 7.5 years, 149 breast cancer cases were documented. Those individuals who possessed “ikigai” (Japanese term meaning something that made one’s life worth living) showed a significantly lower risk of breast cancer (multivariate-adjusted RR = 0.66; 95% confidence interval [CI] = 0.47–0.94). Those who perceived themselves as able to make decisions quickly also had a lower risk of breast cancer (multivariate-adjusted RR = 0.56; 95% CI = 0.36–0.87). The other factors investigated, including ease of anger arousal and self-perceived stress of daily life were not associated with breast cancer risk.

Conclusions

Although further studies will be necessary to verify these findings, our results suggest that having “ikigai” and being decisive decrease an individual’s subsequent risk of breast cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Cohen S, Rodriquez MS (1995) Pathways linking affective disturbances and physical disorders. Health Psychol 14:374–380

    Article  PubMed  CAS  Google Scholar 

  2. Spiegel D, Kato PM (1996) Psychosocial influences on cancer incidence and progression. Harv Rev Psychiatry 4:10–26

    PubMed  CAS  Google Scholar 

  3. Butow PN, Hiller JE, Price MA, Thackway SV, Kricker A, Tennant CC (2000) Epidemiological evidence for a relationship between life events, coping style, and personality factors in the development of breast cancer. J Psychosom Res 49:169–181

    Article  PubMed  CAS  Google Scholar 

  4. Dalton SO, Boesen EH, Ross L, Schapiro IR, Johansen C (2002) Mind and cancer. Do psychological factors cause cancer? Eur J Cancer 38:1313–1323

    Article  PubMed  CAS  Google Scholar 

  5. McKenna MC, Zevon MA, Corn B, Rounds J (1999) Psychosocial factors and the development of breast cancer: a meta-analysis. Health Psychol 18:520–531

    Article  PubMed  CAS  Google Scholar 

  6. Lillberg K, Verkasalo PK, Kaprio J, Teppo L, Helenius H, Koskenvuo M (2001) Stress of daily activities and risk of breast cancer: a prospective cohort study in Finland. Int J Cancer 91:888–893

    Article  PubMed  CAS  Google Scholar 

  7. Lillberg K, Verkasalo PK, Kapr J, Teppo L, Helenius H, Koskenvuo M (2002) A prospective study of life satisfaction, neuroticism and breast cancer risk (Finland). Cancer Causes Control 13:191–198

    Article  PubMed  Google Scholar 

  8. Lillberg K, Verkasalo PK, Kaprio J, Helenius H, Koskenvuo M (2002) Personality characteristics and the risk of breast cancer: a prospective cohort study. Int J Cancer 100:361–366

    Article  PubMed  CAS  Google Scholar 

  9. Lillberg K, Verkasalo PK, Kaprio J, Teppo L, Helenius H, Koskenvuo M (2003) Stressful life events and risk of breast cancer in 10,808 women: a cohort study. Am J Epidemiol 157:415–423

    Article  PubMed  Google Scholar 

  10. Aro AR, De Koning HJ, Schreck M, Henriksson M, Anttila A, Pukkala E (2005) Psychological risk factors of incidence of breast cancer: a prospective cohort study in Finland. Psycho Med 35:1515–1521

    Article  CAS  Google Scholar 

  11. Nakanishi N (1999) ‘Ikigai’ in older Japanese people. Age Ageing 28:323–324

    Article  PubMed  CAS  Google Scholar 

  12. Demura S, Kobayashi H, Kitabayashi T (2005) QOL models constructed for the community-dwelling elderly with ikigai (purpose in life) as a composition factor, and the effect of habitual exercise. J Physiol Anthropol Appl Human Sci 24:525–533

    Article  PubMed  Google Scholar 

  13. Mathews G (1996) What makes life worth living? How Japanese and Americans make sense of their worlds. University of California Press, Berkeley, CA

    Google Scholar 

  14. Shirai K, Iso H, Fukuda H, Toyoda Y, Takatorige T, Tatara K (2006) Factors associated with “Ikigai” among members of a public temporary employment agency for seniors (Silver Human Resources Centre) in Japan; gender differences. Health Qual Life Outcomes 4:12

    Article  PubMed  Google Scholar 

  15. Bass SA (1996) An overview of work, retirement, and pensions in Japan. J Aging Soc Policy 8:57–78

    Article  PubMed  CAS  Google Scholar 

  16. Minami Y, Sasaki T, Arai Y, Hosokawa T, Hisamichi S (2002) Psychological profiles and health status in Japanese female patients with systemic lupus erythematosus: the Miyagi Lupus Collaborative Study. J Epidemiol 12:55–63

    PubMed  Google Scholar 

  17. Nakanishi N, Fukuda H, Tatara K (2003) Changes in psychosocial conditions and eventual mortality in community-residing elderly people. J Epidemiol 13:72–79

    PubMed  Google Scholar 

  18. Weiss RS, Bass SA, Heimovitz HK, Oka M (2005) Japan’s silver human resource centers and participant well-being. J Cross Cult Gerontol 20:47–66

    Article  PubMed  Google Scholar 

  19. Yamamoto-Mitani N, Wallhagen MI (2002) Pursuit of psychological well-being (ikigai) and the evolution of self-understanding in the context of caregiving in Japan. Cult Med Psychiatry 26:399–417

    Article  PubMed  Google Scholar 

  20. Temoshok L (1985) Biopsychosocial studies on cutaneous malignant melanoma: psychosocial factors associated with prognostic indicators, progression, psychophysiology and tumor-host response. Soc Sci Med 20:833–840

    Article  PubMed  CAS  Google Scholar 

  21. Ohno Y, Tamakoshi A (2001) Japan collaborative cohort study for evaluation of cancer risk sponsored by monbusho (JACC study). J Epidemiol 11:144–150

    PubMed  CAS  Google Scholar 

  22. Tamakoshi A, Ohno Y, Inaba Y et al (2005) Profile of the JACC study. J Epidemiol 15(Suppl 1):S4–S8

    Article  PubMed  Google Scholar 

  23. Parkin DM, Whelan SL, Ferlay J, Raymond L, Young J (1997) Cancer incidence in five Continents. IARC, Lyon

    Google Scholar 

  24. Cox DR (1972) Regression models and life tables. J R Stat Soc B34:187–220

    Google Scholar 

  25. WCRF/AICR (1997) Food nutrition and the prevention of cancer: a global perspective. World Cancer Research Fund/American Institute of Cancer Research, Washington DC

    Google Scholar 

  26. Veronesi U, Boyle P, Goldhirsch A, Orecchia R, Viale G (2005) Breast cancer. Lancet 365:1727–1741

    Article  PubMed  Google Scholar 

  27. Ng’andu NH (1997) An empirical comparison of statistical tests for assessing the proportional hazards assumption of Cox’s model. Stat Med 16:611–626

    Article  PubMed  CAS  Google Scholar 

  28. SAS Institute Inc. (1999) SAS/STAT user’s guide. Version 8. Cary, NC

    Google Scholar 

  29. Honma Y, Naruse Y, Kagamimori S (1999) Physio-social activities and active life expectancy, life expectancy in Japanese elderly. Nippon Koshu Eisei Zasshi (in Japanese) 46:380–390

    CAS  Google Scholar 

  30. Breslow L, Breslow N (1993) Health practices and disability: some evidence from Alameda County. Prev Med 22:86–95

    Article  PubMed  CAS  Google Scholar 

  31. Friedman M, Rosenman RH (1971) Type A behavior pattern: its association with coronary heart disease. Ann Clin Res 3:300–312

    PubMed  CAS  Google Scholar 

  32. Temoshok L (1987) Personality, coping style, emotion and cancer: towards an integrative model. Cancer Surv 6:545–567

    PubMed  CAS  Google Scholar 

  33. Viken RJ, Rose RJ, Kaprio J, Koskenvuo M (1994) A developmental genetic analysis of adult personality: extraversion and neuroticism from 18 to 59 years of age. J Pers Soc Psychol 66:722–730

    Article  PubMed  CAS  Google Scholar 

  34. Greer S, Morris T (1975) Psychological attributes of women who develop breast cancer: a controlled study. J Psychosom Res 19:147–153

    Article  PubMed  CAS  Google Scholar 

  35. Jansen MA, Muenz LR (1984) A retrospective study of personality variables associated with fibrocystic disease and breast cancer. J Psychosom Res 28:35–42

    Article  PubMed  CAS  Google Scholar 

  36. Scherg H, Cramer I, Blohmke M (1981) Psychosocial factors and breast cancer: a critical reevaluation of established hypotheses. Cancer Detect Prev 4:165–171

    PubMed  CAS  Google Scholar 

  37. Achat H, Kawachi I, Byrne C, Hankinson S, Colditz G (2000) A prospective study of job strain and risk of breast cancer. Int J Epidemiol 29:622–628

    Article  PubMed  CAS  Google Scholar 

  38. Helgesson O, Cabrera C, Lapidus L, Bengtsson C, Lissner L (2003) Self-reported stress levels predict subsequent breast cancer in a cohort of Swedish women. Eur J Cancer Prev 12:377–381

    Article  PubMed  CAS  Google Scholar 

  39. Steptoe A (1991) The links between stress and illness. J Psychosom Res 35:633–644

    Article  PubMed  CAS  Google Scholar 

  40. Selye H (1986) Stress, cancer, and the mind. In: Day SB (ed) Cancer, stress and death. Plenum Medical Book Company, New York, pp 11–20

    Google Scholar 

  41. Bleiker EM, van der Ploeg HM (1999) Psychosocial factors in the etiology of breast cancer: review of a popular link. Patient Educ Couns 37:201–214

    Article  PubMed  CAS  Google Scholar 

  42. Miyagi Cancer Society (2003) Report on the special survey for cancer prevention in Miyagi Prefecture. Sendai: Department of Public Health and Environment. Miyagi Prefecture

  43. Watanabe S, Tsugane S, Sobue T, Konishi M, Baba S (1996) Baseline data of the Japan Public Health Center-based Prospective Study on Cancer and Cardiovascular Disease (JPHC study). Japan Public Health Association, Tokyo

    Google Scholar 

  44. Iso H, Date C, Yamamoto A et al (2002) Perceived mental stress and mortality from cardiovascular disease among Japanese men and women: the Japan Collaborative Cohort Study for Evaluation of Cancer Risk Sponsored by Monbusho (JACC study). Circulation 106:1229–1236

    Article  PubMed  Google Scholar 

  45. Kojima M, Wakai K, Tokudome S et al (2005) Perceived psychologic stress and colorectal cancer mortality: findings from the Japan Collaborative Cohort Study. Psychosom Med 67:72–77

    Article  PubMed  Google Scholar 

  46. Penninx BW, Guralnik JM, Pahor M et al (1998) Chronically depressed mood and cancer risk in older persons. J Natl Cancer Inst 90:1888–1893

    Article  PubMed  CAS  Google Scholar 

  47. Park Y, Hunter DJ, Spiegelman D et al (2005) Dietary fiber intake and risk of colorectal cancer: a pooled analysis of prospective cohort studies. JAMA 294:2849–2857

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors wish to express their sincere appreciation to K. Aoki (Professor Emeritus at Nagoya University School of Medicine, Japan, and former Chairman of the JACC Study Group) and H. Sugano (former Director of the Cancer Institute of the Japanese Foundation for Cancer Research), who greatly contributed to the initiation of this study. The investigators who co-authored this paper or were involved in the JACC Study (and their affiliations) are as follows: A. Tamakoshi (present Chairman of the study group, Nagoya University Graduate School of Medicine), M. Mori (Sapporo Medical University School of Medicine), Y. Motohashi (Akita University School of Medicine), I. Tsuji (Tohoku University Graduate School of Medicine), Y. Nakamura (Jichi Medical School), H. Iso (Graduate School of Medicine, Osaka University), H. Mikami (Chiba Cancer Center), Y. Inaba (Juntendo University School of Medicine), Y. Hoshiyama (University of Human Arts and Sciences), H. Suzuki (Niigata University School of Medicine), H. Shimizu (Gifu University School of Medicine), H. Toyoshima (Nagoya University Graduate School of Medicine), K. Wakai (Aichi Cancer Center Research Institute), S. Tokudome (Nagoya City University Graduate School of Medical Sciences), Y. Ito (Fujita Health University School of Health Sciences), S. Hashimoto (Fujita Health University School of Medicine), S. Kikuchi (Aichi Medical University School of Medicine), A. Koizumi (Graduate School of Medicine and Faculty of Medicine, Kyoto University), T. Kawamura (Kyoto University Center for Student Health), Y. Watanabe (Kyoto Prefectural University of Medicine Graduate School of Medical Science), T. Miki (Graduate School of Medical Science, Kyoto Prefectural University of Medicine), C. Date (Faculty of Human Life and Environment, Nara Women’s University), K. Sakata (Wakayama Medical University), T. Nose (Tottori University Faculty of Medicine), N. Hayakawa (Research Institute for Radiation Biology and Medicine, Hiroshima University), T. Yoshimura (Fukuoka Institute of Health and Environmental Sciences), A. Shibata (Kurume University School of Medicine), N. Okamoto (Kanagawa Cancer Center), H. Shio (Moriyama Municipal Hospital), Y. Ohno (Asahi Rosai Hospital), T. Kitagawa (Cancer Institute of the Japanese Foundation for Cancer Research), T. Kuroki (Gifu University) and K. Tajima (Aichi Cancer Center Research Institute). The JACC Study has been financially supported by Grants-in-Aid for Scientific Research on Priority Areas from the Ministry of Education, Culture, Sports, Science and Technology of Japan (Nos. 61010076, 62010074, 63010074, 1010068, 2151065, 3151064, 4151063, 5151069, 6279102, 11181101, 17015022, and 18014011).

Author information

Authors and Affiliations

  1. Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan

    Kenji Wakai

  2. Department of Health Promotion and Preventive Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan

    Masayo Kojima, Sadao Suzuki & Shinkan Tokudome

  3. Department of Preventive Medicine/Biostatistics and Medical Decision Making, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Kazuko Nishio, Yoshimitsu Niwa & Akiko Tamakoshi

  4. Department of Public Health, Aichi Medical University School of Medicine, 21 Karimata, Yazako, Nagakute-cho, Aichi-gun, Aichi, 480-1195, Japan

    Yingsong Lin

  5. Department of Medical Technology, Nagoya University School of Health Sciences, 1-1-20 Daiko-minami, Higashi-ku, Nagoya, 461-8673, Japan

    Takaaki Kondo

  6. Department of Public Health/Health Information Dynamics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Hiroshi Yatsuya, Koji Tamakoshi & Hideaki Toyoshima

  7. Infectious Diseases Division, Hyogo Prefectural Institute of Public Health and Environmental Sciences, 2-1-29 Arata-cho, Hyogo-ku, Kobe, 652-0032, Japan

    Akio Yamamoto

Authors
  1. Kenji Wakai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Masayo Kojima
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kazuko Nishio
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sadao Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yoshimitsu Niwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yingsong Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Takaaki Kondo
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hiroshi Yatsuya
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Koji Tamakoshi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Akio Yamamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Shinkan Tokudome
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Hideaki Toyoshima
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Akiko Tamakoshi
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

for the JACC Study Group

Corresponding author

Correspondence to Kenji Wakai.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wakai, K., Kojima, M., Nishio, K. et al. Psychological attitudes and risk of breast cancer in Japan: a prospective study. Cancer Causes Control 18, 259–267 (2007). https://doi.org/10.1007/s10552-006-0111-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-006-0111-x

Keywords

Search

Navigation