The Role of Disease-prone personalities in the Onset of Colorectal Cancer : A Case-control Study

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Background : Although personality factors, especially emotional suppression and loss-hopelessness, have been linked to the occurrence and progression of cancer, little is reported about the role of these factors on the development of colorectal cancer specifically. It has also been claimed that a "hysterical" personality characterized by exaggerated emotional expressions, egocentricity, and ambivalent connection may be protective from cancer. This community-based case-control study examined if personality factors relevant to emotional suppression or loss-hopelessness are associated with an increased risk of colorectal cancer, and if factors related to the hysterical personality are associated with a decreased risk.Methods : The stress inventory (SI), a self-administered questionnaire developed to assess possible disease-prone and other relevant personalities in Japanese, was completed by 497 patients with newly diagnosed colorectal cancer and 809 controls randomly selected in the Fukuoka area of Japan.Results : After controlling for age, sex, and are of residence using a logistic regression model, none of the SI scales relevant to emotional suppression ("unfulfilled needs for acceptance", "altruism" and "rationalizing conflicts/frustrations") or loss-hopelessness ("low sense of control", "object dependence/loss" and "object dependence/happiness") was associated with colorectal cancer. On the other hand, two scales representing elements of the hysterical personality, "object dependence/ambivalence" and "egoism", were protectively associated with risk. Additional adjustment for body-mass index and lifestyle factors did not materially change these associations.Conclusions : While personalities relevant to emotional suppression or loss-hopelessness may not be a risk factor for colorectal cancer in the Japanese population, ambivalent connection and egocentricity may be protective.