Prospective investigation of emotional control and cancer risk in men (the Zutphen Elderly Study) (The Netherlands).
OBJECTIVE
Emotional control is hypothesized to increase cancer incidence and cancer mortality risk. We tested the hypothesis prospectively on all cancers in elderly men.


METHODS
The Zutphen Elderly Study on lifestyle and chronic diseases started in 1985. The total sample consisted of 939 men born between 1900 and 1920 and living in Zutphen (response 74%). In 1985, emotional control was measured by questionnaire with the Courtald Emotional Control Scale (CECS). The CECS consists of three dimensions (anger, anxiety and depression). Emotional control scores were grouped in tertiles. Information on cancer incidence and mortality was collected until December 1994 through general practitioners and hospital administration (119 incidence cases, and 71 deaths from cancer). Cox proportional hazards analyses were performed, adjusted for sociodemographic, psychosocial, and lifestyle-related factors.


RESULTS
Overall emotional control and emotional control of anger and of anxiety were not convincingly related to cancer risk. Intermediate control of depression was related to cancer incidence (fully adjusted RR = 1.7, 95% CI = 1.0-2.8). Both intermediate and high control of depression were related to cancer mortality (RR = 2.2, 95% CI = 1.1-4.6 and RR = 2.1, 95% CI = 1.0-4.3, respectively).


CONCLUSIONS
Our findings provide evidence that control of depression is related to cancer risk.
Tijhuis
M A
MA
Department for Chronic Diseases Epidemiology (CZE), National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands. marja.tijhuis@rivm.nl
Elshout
J R
JR
Feskens
E J
EJ
Janssen
M
M
Kromhout
D
D
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000786:Anger; D001007:Anxiety / Q000150:complications; D015992:Body Mass Index; D003863:Depression / Q000150:complications*; D019260:Expressed Emotion; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D009369:Neoplasms / Q000209:etiology / Q000401:mortality / Q000523:psychology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016019:Survival Analysis