Dr Parikh on Using Chronic Stress Markers to Predict Cancer Risk

In this episode of Community Corner, Ravi B. Parikh, MD, MPP, Winship Cancer Institute of Emory University and Emory University School of Medicine, explores the concept of allostatic load—a measure of the cumulative effects of chronic stress on the body—and how it could potentially help improve cancer risk assessment and prevention, particularly for younger patients.

Allostatic load can be calculated using routinely collected clinical data, including common laboratory values such as hemoglobin A1c and standard vital signs like body mass index. Because these measures are already captured during routine care, Parikh notes that allostatic load has the potential to become a practical and scalable tool in community oncology settings without requiring additional specialized testing.

According to Parikh, emerging evidence suggests that allostatic load may help address a significant gap in predicting early-onset cancers, where existing risk assessment models remain limited. Rather than identifying cancers only after they develop, he highlights the opportunity to incorporate measures of chronic physiologic stress into risk prediction models to better identify patients who may benefit from earlier intervention or enhanced surveillance.

While further prospective validation is needed, Parikh emphasizes that the immediate takeaway for community oncologists is to become familiar with the concept of allostatic load and its potential clinical applications. As research continues to evolve, routinely tracking these readily available markers could lay the groundwork for future risk stratification efforts. He adds that broader adoption will ultimately depend on additional validation studies and on clinical guideline organizations determining when and how allostatic load should be incorporated into cancer prevention and risk assessment recommendations.