Sex Differences in Associations Between Psychosocial Factors and Aberrant Crypt Foci Among Patients at Risk for Colon Cancer

Abstract Background Psychosocial factors may impact cancer risk but sex differences in this domain are understudied. Examining psychosocial factors, such as depression and social support, among colon cancer patients allows for a unique opportunity to study sex differences in the association between psychosocial factors and colon cancer risk in this population. Objective The primary aim of this study was to evaluate sex differences in the association between key psychosocial factors and aberrant crypt foci (ACF), a putative biomarker of colon cancer risk. We hypothesized that higher levels of depression in women and lower levels of social support in men were associated with greater numbers of ACF among individuals at heightened risk for colon cancer. Methods Participants were self-referred or referred by physicians for routine colonoscopy. Within 2 weeks before colonoscopy, participants completed standardized measures assessing psychosocial factors. At colonoscopy, individuals were examined for ACF frequency in the distal 20 cm of the colorectum. Regression β weights were used to examine the association between the psychosocial factors and ACF. Results A total of 93 individuals (51% women, 49% men) consented to the study. Among women, higher levels of depressive symptoms were associated with greater numbers of ACF; among men, lower levels of social support were associated with greater numbers of ACF. Conclusions These results suggest that although colon cancer affects men and women equally with regard to morbidity and mortality rates, there were important sex differences in how psychosocial variables were related to colon cancer risk. Psychosocial interventions aimed at targeting these types of factors are warranted but need to consider the role of sex.