The role of personality in the course of health-related quality of life and disease-specific health status among colorectal cancer survivors: A prospective population-based study from the PROFILES registry

Background. Prospective studies in various cardiovascular populations show that Type D personality predicted impaired health-related quality of life (HRQoL) and disease-specific health status. We examined the effect of negative affectivity (NA), social inhibition (SI) and their combined effect (Type D personality) on HRQoL and disease-specific health status among colorectal cancer (CRC) patients. Methods. CRC patients diagnosed between 2000 and 2009, as registered in the Dutch population-based Eindhoven Cancer Registry, received questionnaires on Type D personality (DS14), HRQoL (EORTC QLQ-C30) and disease-specific health status (EORTC QLQ-CR38) in 2010, 2011 and 2012. Results. Response rates were 73% (n = 2625), 83% (n = 1643) and 82% (n = 1458), respectively. Analyses were done on those completing at least two questionnaires (n = 1735). Individuals with Type D (NA+/SI+; 19%) and high NA (NA+/SI-; 11%) reported a significantly worse HRQoL and disease-specific health status compared to NA-/SI+ and NA-/SI-. Differences were stable over time. Linear mixed effects models showed that Type Ds had a lower quality of life, cognitive and emotional functioning, more insomnia, diarrhea, gastrointestinal, defecation and stoma-related problems and poor body image and future perspective compared to the reference group (NA-/SI-), even after controlling for sociodemographic and clinical variables. High NA individuals (NA+/SI-) reported similar poor health outcomes as Type Ds. However, they also reported lower social functioning and more fatigue, pain, micturition- and financial problems, while Type Ds reported more constipation, sexual problems and less sexual enjoyment. Conclusions. Type D personality and high NA both have a significant negative stable impact on HRQoL and disease-specific health status among CRC patients.