Is neuroticism relevant for old cancer survivors? A controlled, population-based study (the Norwegian HUNT-3 survey)

Exploring the Impact of Neuroticism on Lung Cancer Risk: Insights From Mediated Mendelian Randomization

OBJECTIVE

This study aimed to explore the potential association between neuroticism and lung cancer.

METHODS

We conducted analyses on publicly accessible aggregated data from genome-wide association studies (GWAS) that included individuals of European descent. The objective was to identify single nucleotide polymorphisms (SNPs) significantly associated with neuroticism and utilize them as instrumental variables in a two-sample Mendelian randomization framework to evaluate the gender-specific causal link between neuroticism and lung cancer risk. We applied four statistical methods: Inverse variance weighting (IVW), weighted median, MR-Egger regression, and weighted mode. Our analysis also considered the mediating effect of educational attainment on this relationship.

RESULTS

We selected 67 SNPs associated with neuroticism at genome-wide significance levels from GWAS datasets. Our primary findings using IVW suggest a notable increase in lung cancer risk associated with neuroticism across the general population (odds ratio [OR] = 1.175; 95% confidence interval [CI] 1.020-1.354, p = 0.026). Gender-specific analysis revealed that neuroticism posed a slight but significant risk increase in men (OR = 1.006; 95% CI 1.000-1.012, p = 0.045) and women (OR = 1.005; 95% CI 1.002-1.009, p = 0.002), with findings corroborated by the additional statistical methods. Further, evidence from both observational and Mendelian randomization analyses suggests that genetically predicted neuroticism is causally associated with a modestly increased risk of incident lung cancer, with ∼17% of this effect mediated by educational attainment.

CONCLUSIONS

The results from this Mendelian randomization study provide robust evidence supporting a potential association between neuroticism and an increased risk of lung cancer. This association appears more pronounced in men than women. Additionally, educational level serves as a mediator in the nexus between these conditions, suggesting that interventions aimed at increasing educational attainment might mitigate some of the risk neuroticism poses for developing lung cancer.

Exploring the bidirectional causality between neuroticism and frailty: a Mendelian randomization analysis

BACKGROUND

Epidemiological studies have confirmed the relationship between personality trait neuroticism and physical health. However, the relationship between neuroticism and frailty remains unconfirmed. This study employed a bi-directional two-sample Mendelian randomization (MR) approach to investigate the causal relationship between neuroticism and frailty.

METHODS

The neuroticism genome-wide association study (GWAS) data from the UK Biobank contained twelve neuroticism-related traits with 489,212 participants. The genetic frailty index data were extracted from the UK Biobank and Swedish TwinGene, involving 175,226 individuals. Independent genetic variants associated with neuroticism and frailty were selected as instrumental variables. Inverse variance weighted (IVW), MR-Egger, weighted median, weighted mode, and MR-PRESSO were mainly used for MR analysis.

RESULTS

The MR analysis showed a positive causal relationship between neuroticism and the risk of frailty (odds ratio (OR) = 1.627, 95% confidence interval (CI) = 1.538-1.722, P < 0.001). In the reverse direction, frailty had a causal effect on a higher risk of neuroticism (OR = 1.270, 95% CI = 1.173-1.375, P < 0.001). Steiger tests indicated that reverse causation did not bias the identified causal relationships.

CONCLUSIONS

Our study provides genetic evidence suggesting a bi-directional causal relationship between frailty and neuroticism. In this bi-directional MR study, there were positive causal relationships between neuroticism-related phenotypes and frailty, and in the reverse direction, frailty was also positively correlated with neuroticism.

Subjective cognitive functioning in patients with cancer: A network approach

PURPOSE

The current study aimed to (1) examine the sociodemographic, clinical and psychological factors related to subjective cognitive functioning (SCF); (2) analyze the complex mutual interconnections between SCFs; and (3) address patients' perspectives on SCF and supportive care.

METHOD

A heterogeneous sample of oncological patients (N = 566) was recruited.Items inquiring about the senses, attention, memory, spatial functions, decision-making and speech were administered. A network of subjectively perceived changes in cognitive functions was estimated while three open-ended questions addressed patients' perspectives on SCF.

RESULTS

Within the network, deficits in spatial perception, attention focus and problem-solving ability had the highest strength index while the deficits related to the senses were the least influential.

CONCLUSION

The findings indicate that psychological-based interventions focused on higher cognitive functions could improve patients' quality of life. The presence of supportive care and available information could strengthen SCF intervention and prevention for patients with cancer.

Work status changes and associated factors in a nationwide sample of Norwegian long-term breast cancer survivors

PURPOSE

The study aims to describe work status at diagnosis and 8 years post-diagnosis in a nationwide sample of breast cancer survivors (BCSs), and investigate associated and self-reported factors of reduced work status.

METHODS

Women aged 20-65 years when diagnosed with stage I-III breast cancer (BC) in 2011 or 2012 were invited to participate in a questionnaire study in 2019 (n = 2803), of whom 49% (n = 1361) responded. For this sub-study, we included 974 BCSs below the legal retirement age in Norway (< 67 years) at survey and with complete work status data. Reduced work status was defined as being in paid work at BC diagnosis and not working at time of survey. Logistic regression analyses were applied to identify factors associated with reduced work status.

RESULTS

Of BCSs who were in paid work at diagnosis (n = 845), 63% maintained their work status to 8 years later. Reduced work status was associated with not living with children (OR .44, 95% CI .24-.82), age (OR 1.16, 95% CI 1.11-1.21), chemotherapy (OR 2.83, 95% CI 1.24-6.61), > 2 comorbid conditions (OR 2.27, 95% CI 1.16-4.32), cognitive function (OR .99, 95% CI .98-.99), fatigue (OR 1.02, 95% CI 1.01-1.03), and neuroticism (OR 1.57, 95% CI 1.00-2.46). BC and late effects were reported as reasons for reduced work status and disability.

CONCLUSIONS

The majority of BCSs who were in paid work at diagnosis were working 8 years later.

IMPLICATIONS FOR CANCER SURVIVORS

Our results suggest a need to focus on fatigue and reduced cognitive function among long-term BCSs, with the ultimate aim of improving work sustainability.

Distress in hospitalized cancer patients: Associations with personality traits, clinical and psychosocial characteristics

OBJECTIVE

To improve allocation of psychosocial care and to provide patient-oriented support offers, identification of determinants of elevated distress is needed. So far, there is a lack of evidence investigating the interplay between individual disposition and current clinical and psychosocial determinants of distress in the inpatient setting.

METHODS

In this cross-sectional study, we investigated 879 inpatients with different cancer sites treated in a German Comprehensive Cancer Center. Assessment of determinants of elevated distress included sociodemographic, clinical and psychosocial characteristics as well as dimensions of personality. Multiple linear regression was applied to identify determinants of psychosocial distress.

RESULTS

Mean age of the patients was M = 61.9 (SD = 11.8), 48.1% were women. In the multiple linear regression model younger age (β = -0.061, p = 0.033), higher neuroticism (β = 0.178, p = <0.001), having metastases (β = 0.091, p = 0.002), being in a worse physical condition (β = 0.380, p = <0.001), depressive symptoms (β = 0.270, p = <0.001), not feeling well informed about psychological support (β = 0.054, p = 0.046) and previous uptake of psychological treatment (β = 0.067, p = 0.020) showed significant associations with higher psychosocial distress. The adjusted R² of the overall model was 0.464.

CONCLUSION

Controlling for sociodemographic characteristics and dispositional vulnerability, that is neuroticism, current clinical and psychosocial characteristics were still associated with hospitalized patients' psychosocial distress. Psycho-oncologists should address both, the more transient emotional responses, such as depressive symptoms, as well as more enduring patient characteristics, like neuroticism.

Personality Factors in Colorectal Cancer: A Systematic Review

Background: The role of personality in cancer incidence and development has been studied for a long time. As colorectal cancer (CRC) is one of the most prevalent cancer types and linked with lifestyle habits, it is important to better understand its psychological correlates, in order to design a more specific prevention and intervention plan. The aim of this systematic review is to analyze all the studies investigating the role of personality in CRC incidence. Methods: All studies on CRC and personality up to November 2020 were scrutinized according to the Cochrane Collaboration and the PRISMA statements. Selected studies were additionally evaluated for the Risk of Bias according to the Newcastle-Ottawa Scale (NOS). Results: Eight studies met the inclusion criteria and were eventually included in this review. Two main constructs have been identified as potential contributors of CRC incidence: emotional regulation (anger) and relational style (egoism). Conclusion: Strong conclusions regarding the influence of personality traits on the incidence of CRC are not possible, because of the small number and the heterogeneity of the selected studies. Further research is needed to understand the complexity of personality and its role in the incidence of CRC and the interaction with other valuable risk factors.