Asia Pacific Environmental and Occupational Health Journal

Objective: This cross sectional study was conducted in Selangor. The main objective of the study was to determine the association between stress and cortisol levels among breast cancer survivors.

Method: Forty seven respondents with a history of breast cancer were selected as the survivor group and 37 respondents without the history of breast cancer were selected as the comparative group. Stress levels were determined by using the O’Donnell Stress Questionnaire (Personal Stress Inventory). Respondents with total score of more than 40 were classified as stressed. Saliva samples were collected from each respondent and cortisol level was determined using the Elisa-kit (Salivary Cortisol Enzyme Immunoassay-Kit).

Result: Findings showed that the mean and standard deviation for the cortisol level among the survivor group in the morning was 3.392 μg/dL and 0.873μg/dL respectively, while in the evening the mean was 4.89 μg/dL with a standard deviation of 0.852μg/dL. There was a significant difference (p<0.001) between the mean of the early morning cortisol level with the late evening cortisol level. However, statistics showed no significant difference between the morning and evening cortisol levels of the survivor group with that of the comparative group. The mean stress scores of the survivor group was significantly higher than the comparative group (z = -0.861, p = 0.389).

Conclusion: The stress level in terms of nutritional status, physical problem, depression and the need for attention were significantly related with the cortisol hormone level. However, no significant difference in the salivary cortisol level between the survivor and comparative groups were found.

Keywords: Salivary cortisol, stress and breast cancer survivors