Published in Cancer Detection and Prevention 2005; 29(1).

The associations between psychological distress and cancer prevention practices

Keiko Honda PhD, MPH, Renee D. Goodwin PhD, MPH, Alfred I. Neugut MD, PhD

Department of Epidemiology, Columbia University, 722 West 168th St. 7th Fl, New York, NY 10034, USA

The aim of the current study was to determine the extent to which psychological distress is associated with cancer prevention practices among otherwise healthy adults in the community (N = 30,223). Using data from the 2000 National Health Interview Survey, a series of multiple logistic regression analyses were used to estimate the associations between psychological distress and selected cancer prevention practices. Results indicate that psychological distress was directly associated with an increased likelihood of daily cigarette smoking, physical inactivity, and obesity. Only smoking status mediated the relation between psychological distress and perceived cancer risk. Individuals who reported higher psychological distress were more likely to engage in specific cancer screenings before reaching the recommended age. This effect was partially mediated by perceived cancer risk. The higher levels of cigarette smoking and physical inactivity among psychologically distressed adults support the need for integration of cancer prevention and mental health interventions to reduce specific cancer risk in highrisk adults. Further research is needed to differentiate the causal pathways and mechanisms linking heightened individual cancer risk, potentially comorbid mental disorders or psychological conditions, and cancer screening adherence.

KEY WORDS: Psychological issues, Cancer prevention behaviors, Personal cancer risk, Risk behaviors, Epidemiology.