Table 1.

Personality and colorectal cancer: description of the selected studies.

References	Study design	Population	Psychological assessment tools	Personality outcome	Timing of measurement	Main results	Note
Lemogne et al. (2013)	Cohort study	124 CRC (106m, 18f); 368 prostate cancer, 146 breast cancer, 137 smoking related cancers (132M, 5F), 352 other cancers (256m, 96f) Country: France	- Personality Stress Inventory - Buss and Durkee Hostility Inventory - Bortner Type A Rating Scale	Type 1(suppress negative emotions), Type 5 personalities (rational anti-emotional), Hostility, Type A behavior pattern (time urgency, competitiveness, need for achievement)	Personality questionnaires: at baseline Cancer incidence: retrieved through annual follow-ups (maximum 16-year follow-up from baseline)	No association between Type 1 (suppress negative emotions) and CRC No association between Type 5 (rational anti-emotional) and CRC No association between Hostility and CRC No association between Type A behavior pattern (time urgency, competitiveness, need for achievement)	- Risk of false negative cases. - Mailed questionnaire
Nakaya et al. (2010)	Cohort study	376 CRC, 180 stomach, 364 lung, 908 breast, 105 liver, 140 pancreas, 113 cervix uteri, 138 corpus uteri, 479 prostate, 122 kidney, 172 urinary organs, 170 melanoma, 220 nervous system Country: Finland and Sweden	Eysenck Personality Inventory	Extraversion, Neuroticism	Personality Questionnaire: at baseline Cancer incidence: national tumor registry with a maximum follow-up of 30 years	No association between personality traits and CRC incidence	- Delivered questionnaire
Nagano et al. (2008)	Case-control study	497 CRC (288 m, 209 f), 809 healthy controls (502 m, 307 f) Mean age for CRC: 59 yrs Country: Fukuoka (Japan)	Stress Inventory	Emotional suppression (unfulfilled needs for acceptance); Loss-hopelessness (Low sense of control, Object-dependence/loss, Object-dependence/happiness); Hysterical personality (“object dependence/ambivalence” and “egoism”).	Personality questionnaires: at the histologically confirmation of diagnosis (before or after surgery) Healthy controls: before or after surgery	Weak positive association between object-dependence/happiness and CRC (p = 0.05). Negative association between hysterical personality (object-dependence/ambivalence (p = 0.04) and egoism (p = 0.01) and CRC risk.	- The reason for the selection of some sub-scales is unclear. - The selection of items for Hysterical personality is weak. - Participation rate higher for cases (74%) than controls (59%).
Kreitler et al. (2008)	Case-control study	230 CRC (: 101 m 129 f); 165 healthy (55 m 110 f ), 90 Crohn's disease (49 m, 41 f) M. Age for CRC: 61.54	Cognitive Orientation Questionnaire	Beliefs	Patients: at the time of treatment or follow-up Healthy controls: in their working place	Positive association between Cognitive Orientation and CRC (p < 0.001): - Positive association between Conflict in self-effacement vs. self-assertion - Positive association between Conflict in closeness to others vs. distancing from others	- the methodology is poorly described - the factors measured by the CO questionnaire include a variety of different themes - difficult to say if the beliefs are the cause or the effect of cancer.
White et al. (2007)	Cohort Study	280 CRC, 352 breast, 318 prostate, 88 lung, 261 melanoma, 653 other Range: 27–75 years, M. Age - CRC: 61.8 Country: Melbourne (Australia)	7-item anger control subscale (from Courtauld Emotional Control Scale); Positive and Negative Affect Scale	Anger control, Negative affect	Baseline (healthy population) Average follow-up of 9 years	- -Positive association between anger control and presence of CRC; - Positive association between Negative affect and presence of CRC - weak positive associations between negative affect and colorectal cancer after adjusting for risk factors (the association between anger control and colorectal cancer was slightly stronger, excluding the first 2 years of follow-up).	- the measurement of negative affect and anger control might not be stable over several years.
Nakaya et al. (2003)	Cohort study	186 CRC, 229 stomach, 108 lung, 87 breast Country: rural northern Japan	Eysenck Personality Questionnaire -Revised Short Form	Extraversion, Neuroticism, Psychoticism	7 year follow-up (for prospective design)	No association with CRC	- Delivered questionnaire - the number of cases of cancer for single site is modest and the statistical power might not be sufficient. - Neuroticism showed significant association at 3 year but not 7 year follow-up for all cancer site incidence.
Kavan et al. (1995)	Case-matched control study	61 CRC veterans; 61 healthy veterans, 100% males M. age: na Country: Minneapolis (USA)	21-factor Minnesota Multiphasic Personality Inventory	Aggressive hostility, Psychoticism-Peculiar Thinking, Cynicism-Normal Paranoia, Stereotypic Femininity and Masculinity, Psychotic Paranoia, Assertiveness, Intellectual Interests, Dreaming, Denial of Somatic Problems, Neurasthenic somatization, Sexual adjustment, Well-being – Health, Family Attachment, Social extraversion, Delinquency, Inner Directedness, Religious Fundamentalism, Phobias, Neuroticism Depression	5–37 years (M = 20.5) premorbid assessment Healthy controls: information non-specified	- Positive association between aggressive hostility (p < 0.018) and CRC incidence; - Positive association between phobias (p < 0.05) and CRC stage of presentation - Negative association between religious fundamentalism (p < 0.05) and CRC stage of presentation - No association in the other subscales	Premorbid assessment further supports findings
Kune et al. (1991)	Case-matched control study	637 CRC (346 m, 291 f); 714 healthy controls (391 m, 323 f); Mean age: 65 Yrs. Country: Melbourne (Australia)	Questionnaire on cancer-prone personality	Commitment to conformity with social norms, Negative emotions repression or denial, suppression	Not reported	- combined score for cancer personality questions (commitment to conformity with social norms, negative emotions repression or denial, suppression, low anxiety, conflict avoidance) differed significantly (p < 0.001) - positive association between anger subscale (repression, denial, non-expression of anger) and CRC (p < 0.001) - stronger positive association between denial of anger and CRC in women (p = 0.005) - Positive association between Commitment to conformity with social norms and CRC in women (p = 0.005)	- Risk of recall bias - Questionnaire structured ad hoc (no validation against other measures) - 5% of cases did not know if they were affected by CRC

CRC, colorectal cancer; ICD-9, International Classification of Diseases.