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Japanese Journal of Clinical Oncology Advance Access originally published online on July 30, 2008
Japanese Journal of Clinical Oncology 2008 38(8):553-561; doi:10.1093/jjco/hyn067
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© The Author (2008). Published by Oxford University Press. All rights reserved

Personality and Colorectal Cancer: The Fukuoka Colorectal Cancer Study

Jun Nagano1,2, Suminori Kono2, Kengo Toyomura2, Tetsuya Mizoue2, Guang Yin2, Ryuichi Mibu3, Masao Tanaka3, Yoshihiro Kakeji4, Yoshihiko Maehara4, Takeshi Okamura5, Koji Ikejiri6, Kitaroh Futami7, Yohichi Yasunami8, Takafumi Maekawa9, Kenji Takenaka10, Hitoshi Ichimiya11 and Nobutoshi Imaizumi12

1 Institute of Health Science, Kyushu University
2 Department of Preventive Medicine
3 Department of Surgery and Oncology
4 Department of Surgery and Science, Kyushu University Graduate School of Medical Sciences
5 Division of Surgery, National Kyushu Cancer Center
6 Division of Surgery, National Kyushu Medical Center
7 Department of Surgery, Fukuoka University Chikushi Hospital
8 The First Department of Surgery
9 The Second Department of Surgery, Fukuoka University School of Medicine
10 Division of Surgery, Fukuoka City Hospital
11 Division of Surgery, Hamanomachi General Hospital
12 Division of Surgery, Fukuoka Red Cross Hospital, Fukuoka, Japan

For reprints and all correspondence: Jun Nagano, Institute of Health Science, Kyushu University, 6-1 Kasuga Park, Kasuga, Fukuoka 816-8580, Japan. E-mail: nagano{at}ihs.kyushu-u.ac.jp

Received May 22, 2008; accepted July 2, 2008

Objective: Although personality factors, especially emotional suppression and loss-hopelessness, have been linked to the occurrence and progression of cancer, little is reported specifically on colorectal cancer. 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 whether personality factors relevant to emotional suppression or loss-hopelessness are associated with an increased risk of colorectal cancer, and whether factors related to the hysterical personality are associated with a decreased risk.

Methods: The stress inventory (SI), a self-administered questionnaire to assess the 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 residence using a logistic regression model, none of the SI scales relevant to emotional suppression (‘unfulfilled needs for acceptance’, ‘altruism’, ‘rationalizing conflicts/frustrations’) or loss-hopelessness (‘low sense of control’, ‘object-dependence/loss’, ‘object-dependence/happiness’) was related to 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: Although personalities relevant to the 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.

Key Words: colorectal neoplasms • personality • stress, psychological • risk factors • case–control studies


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