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Cancer history may affect link between psychological distress and cancer mortality

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Does psychological distress increase the risk of death from cancer?


A nationally representative sample of 15 453 men and women (aged 53–65 years, 44.9% male, with a mean follow-up period of 7.0 (3.3) years) surveyed in 1995, 1998 and 2003 as part of the Scottish Health Survey. In this sample, there were 295 people with a history of cancer.


Scotland, UK; 1995–2006.

Risk factors:

Psychological distress, including symptoms of anxiety, depression and post-traumatic stress symptoms, as assessed with the General Health Questionnaire (GHQ-12), with a conventional cut-off score of ⩾4 to detect psychological distress. The risk of cancer mortality in relation to psychological distress was calculated, with months as the time scale, using the Cox proportional hazards models. Analyses were adjusted for age, gender, socioeconomic groupings, marital status, body mass index, smoking, alcohol intake, physical activity and survey year (1995, 1998 or 2003).


Rate of cancer mortality (ICD-9 and ICD-10 classification). Data on cancer mortality for the period 1995–2006 was coded according to the International Classification …

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  • Source of funding The British Heart Foundation, The Scottish Executive and the Kanae Foundation, Japan.


  • Competing interests None.

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