Is cancer risk associated with anger control and negative affect? Findings from a prospective cohort study

Objective: To examine the associations between anger control and negative affect and the risk of five common cancers and total cancers. Possible associations between emotional states and the risk of cancer have long been postulated. Methods: Prospective cohort study with average follow-up of 9 years. A total of 19,730 adults (99% aged between 40 and 69 years) answered questions on negative affect and anger control at baseline. A total of 1952 cancers were diagnosed, including 352 breast cancers, 318 prostate cancers, 88 lung cancers, 280 colorectal cancers, and 261 melanomas. Results: After adjustment for potential confounders, there was no significant association between anger control or negative affect and risk of breast cancer, melanoma, or total cancers. Weak associations were identified between anger control and prostate cancer, hazards ratio (HR) 1.17 (1.04-1.30) for a 1-unit increase in the standardized scale, negative affect, and lung cancer, HR 1.24 (1.01-1.52) and colorectal cancer, HR 1.14 (1.01-1.28). There was no evidence of an interaction effect between anger control and negative affect. Conclusions: Results suggest that anger control and negative affect are not associated with breast cancer, melanoma, or total cancer risk, although they may have a small role in risk of prostate, colorectal, and lung cancer. Although more research is needed to confirm these latter associations, the results suggest that if affective states are associated with cancer development, the association may differ for different cancers and argue against the use of total cancer as an outcome measure for studies in this area.