The Biopsychosocial Impact of Stress and Mental Health on Cancer Risk

Abstract

Cancer remains one of the most pressing global health concerns, with incidence rates rising despite advancements in early detection and prevention. While genetic, lifestyle, and environmental factors are well-established contributors to cancer risk, the role of stress and mental health in cancer development is an emerging area of research. Chronic stress, major life stressors, mental health disorders (e.g., anxiety, depression, post-traumatic stress disorders), and hazardous substance use are increasingly recognized for their potential to influence cancer incidence. These psychosocial factors may impact biological pathways related to immune system function, inflammation, and hormonal dysregulation, yet their precise contribution to cancer risk remains underexplored. This scoping review aims to synthesize existing literature to evaluate the biopsychosocial impact of stress, mental health, and substance use on cancer risk. A scoping review was conducted following PRISMA guidelines, analyzing studies published between 1985 and 2024. Selected studies examined associations between stress, mental health, substance use, and cancer risk, focusing on biological and behavioral pathways. The review highlights multiple pathways through which stress, mental health, and substance use may influence cancer risk. Chronic stress and mental health conditions have been associated with dysregulation of the hypothalamic–pituitary– adrenal axis, immune suppression, and increased inflammation, all of which are implicated in cancer progression. Studies also indicate that major life stressors can contribute to cancer risk by triggering prolonged physiological stress responses. Additionally, hazardous substance uses behaviors, including alcohol and tobacco consumption, frequently co-occur with stress and mental health disorders, serving as indirect mediators that further elevate cancer risk. Findings suggest that individuals with PTSD, depression, or anxiety may be at a higher risk for specific cancers, including breast, colorectal, lung, and prostate cancers. Finally, there is a dose-response between substance use and risk of cancer. Notably, even the lowest amount of alcohol and tobaccos use increase the risk of cancer. While epidemiological studies support an association between stress, mental health, and cancer, causality remains challenging to establish due to confounding variables and reliance on self-reported data. This scoping review underscores the complex interplay between psychological stress, mental health, and cancer risk, highlighting the need for an integrated approach to cancer prevention that includes mental health management. Addressing modifiable risk factors could enhance cancer prevention strategies by mitigating both direct biological effects and indirect behavioral influences. Future research should focus on longitudinal studies to establish causal relationships and explore potential interventions targeting stress reduction and mental health support as part of comprehensive cancer prevention programs.