title: Poor self-rated health associated with an increased risk of subsequent development of lung cancer.
abstract: OBJECTIVE
  Self-rated health has shown to be a strong predictor of mortality and some major chronic diseases. The purpose of this study was to investigate whether poor self-rated health also was related to an increased risk of subsequent development of cancer.
  
  
  METHODS
  Information on self-rated health, life-style factors, and other health-related risk factors was ascertained in a cohort of 25,532 persons participating in the Hordaland Health Study in 1997-1999. Information on development of cancer during 10 years of follow-up was obtained from the Norwegian Cancer Registry. The relationship between self-rated health and development of cancer was examined using Cox regression analysis adjusting for smoking and other life-style factors.
  
  
  RESULTS
  Respondents reporting a poor health showed a non-significant increased risk of overall cancer. Sub-analysis of the four most common types of cancer showed a statistically significant association between self-rated health and lung cancer. The adjusted hazard ratio was 3.88 (95% CI; 0.99, 15.8) for those rating their health as poor compared to very good (p for trend = 0.038). For the other types of cancer, we found a non-significant elevated risk associated with poor self-rated health.
  
  
  CONCLUSIONS
  Respondents who perceive their health as poor had an increased risk of developing lung cancer also after adjusting for smoking. This suggests that self-rated health reflects a broad range of factors important for development of this cancer type. Nevertheless, due to the explorative analysis of the specific cancer types, these findings need to be repeated before elaborate interpretations can be made.
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Postbox 7804, 5020, Bergen, Norway, hildekriise@hotmail.com.
authors.forename: Hilde Kristin Refvik
authors.initials: HK
authors.lastname: Riise
authors.forename: Trond
authors.initials: T
authors.lastname: Riise
authors.forename: Gerd Karin
authors.initials: GK
authors.lastname: Natvig
authors.forename: Anne Kjersti
authors.initials: AK
authors.lastname: Daltveit
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002908:Chronic Disease / Q000453:epidemiology / Q000523:psychology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D008019:Life Style; D008175:Lung Neoplasms / Q000453:epidemiology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000523:psychology; D009664:Norway / Q000453:epidemiology; D016016:Proportional Hazards Models; D011788:Quality of Life; D012042:Registries; D012044:Regression Analysis; D012307:Risk Factors; D057566:Self Report; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires