Mapping Psychosocial Determinants for Cancer Onset: An Umbrella Review.
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BACKGROUND: Despite the growing body of literature suggesting that psychosocial factors contribute to cancer susceptibility, the existing evidence remains heterogeneous, and it is unclear which domains show the most consistent associations. Systematically mapping this literature helps inform the integration of psychosocial factors into cancer risk assessment and management frameworks, alongside behavioural risk factors. METHODS: To synthesise existing evidence on psychosocial factors associated with cancer onset, we conducted an umbrella review within the EU-funded iBeChange project (ID:101136840). Following Joanna Briggs Institute (JBI) methodology, PRISMA 2020 and SWiM guidelines, we included systematic reviews and meta-analyses examining psychosocial exposures in relation to cancer risk or incidence. Searches were conducted in PubMed, Embase, and Scopus, and methodological quality was assessed using ROBIS. RESULTS: Forty-one reviews were included. Across psychosocial domains, the consistency of evidence varied considerably. Depression showed the most robust low-risk-of-bias evidence, particularly for lung and overall cancer risk. Adverse childhood experiences showed high concordance across reviews with a dose-response gradient, though all reviews were rated at high risk of bias. Urbanicity, composite socioeconomic status, and anxiety showed moderate or variable patterns, while stressful life events, socioeconomic indicators, and coping strategies were characterised by low consistency and very high heterogeneity. Evidence for psychiatric diagnoses and psychological distress was limited to single reviews. Approximately one third of the included reviews were rated at low risk of bias. CONCLUSIONS: This umbrella review identifies psychosocial domains that should be considered in relation to cancer risk, providing a foundation for expanding prevention models beyond traditional behavioural risk factors towards multidimensional, psychosocially informed approaches. Lower-consistency domains should not be prematurely dismissed, as current evidence gaps may reflect methodological limitations rather than true absence of effect. Further high-quality longitudinal studies are needed to clarify underlying mechanisms and support the integration of psychosocial factors into cancer prevention strategies.