1: Psychological distress increases the risk of dying from prostate cancer
A study published in the British Medical Journal (BMJ) shows that individuals with higher psychological distress are at increased risk of dying of cancer. The association was particularly strong for leukaemia, colorectal, oesophageal and prostate cancers. The study pooled data from 16 prospective studies, initiated from 1994-2008 in England and Scotland, where baseline distress information was collected using the General Health Questionnaire (GHQ-12). Analysis involved over 160 000 participants and during the study there were 16 267 deaths, of which 4353 were from cancer.
Overall, people in the highest distress grouping had a significantly increased rate of death from cancer compared to people in the lowest distress grouping (HR 1.32; 95% CI 1.18-1.48). Results were adjusted for confounding factors including age, sex, education, smoking and body mass index. When broken down by tumour site, distress was associated with a significantly increased risk of dying of prostate cancer (HR 2.29; 95% CI 1.36-3.86). In addition, for prostate and colorectal cancers a gradient was seen where there was an increased risk of death with each step-wise increase in distress. While this study does not prove that distress is causal to poorer outcomes, it suggests that future work should explore the lifestyle and biological factors associated with distress that may influence cancer mortality.