Do sleep quality and psychological factors link precancerous conditions of colorectal cancer? A retrospective case-control study

ABSTRACT

Background

Little is known about the effect of sleep quality on the risk of precancerous conditions of colorectal cancer (PCRC). The role of psychological factors, including stress, resilience, and social support as closely related factors of sleep quality, was also discussed.

Research Design and Methods

Fifty-one patients with PCRC were compared with two control groups during the previous year in a retrospective case-control analysis: 74 patients with colorectal cancer and 145 healthy controls. Participants completed questionnaires measuring sleep quality, perceived stress, resilience, and social support one year prior to disease diagnosis. Univariate and multivariate logistic regression models were used to analyze the data.

Results

Increased risk of PCRC was associated with sleep disturbance≥2 and the negative factors of stress ≥14 compared with healthy controls. Decreased risk of PCRC was associated with resilience ≥31 and family support ≥18. In a multivariate model, sleep disturbance≥2 was significantly associated with an elevated risk of PCRC (OR = 20.15, 95% CI: 4.22 to 96.26).

Conclusions

Physicians should be aware of the strong association between sleep disturbance≥2 and the increased risk for PCRC and explain the need for colonoscopy in patients with sleep disturbance≥2.

KEYWORDS:

• Precancerous conditions
• colorectal cancer
• sleep disorders
• stress
• social support
• resilience

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Abbreviations

CRC, colorectal cancer; HC, healthy controls; PCRC, precancerous conditions of colorectal cancer; PSQI, Pittsburgh Sleep Quality Index; PSS, Perceived Stress Scale; MSPSS, The Multidimensional Scale of Perceived Social Support; CD-RISC, Connor-Davidson Resilience Scale.

Data transparency statement

Individual participant data that underlie the reported results will be made available 3 months after publication for a period of 5 years after the publication date at http://www.chictr.org. The study protocol is also available at the same website.

Author contributions

W Liu contributed to the conception, design, analysis, and interpretation of the data, the drafting of the manuscript, and the final approval of the published version. H Zhang assisted in collection and interpretation of the data. All authors agree to be accountable for all aspects of the work.