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Psychooncology. 2019 Oct 30. doi: 10.1002/pon.5272. [Epub ahead of print]

Depressive symptoms, neuroticism, and participation in breast and cervical cancer screening: Cross-sectional and prospective evidence from UK Biobank.

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Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.



To assess the cross-sectional and prospective associations between depressive symptoms, neuroticism, and participation in breast and cervical screening in the UK.


Women in the UK Biobank cohort with complete data who were eligible for breast cancer screening (aged 50-70 years, N = 143 461) and/or cervical screening (<65 years, N = 141 753) at baseline recruitment (2006-2010) and those with follow-up data (2014-2019) were identified (N = 11 050 and N = 9780 for breast and cervical screening). Depressive symptoms and neuroticism were self-reported at baseline (range 0-12 with higher scores reflecting greater severity). Primary outcomes were reporting being up to date with breast and cervical screening. For prospective analyses, patterns of screening participation from baseline to follow-up were identified. Logistic regression was used to analyse associations, adjusted for potential confounding factors.


More severe depressive symptoms were associated with reduced likelihood of breast (OR = 0.960, 95% CI: 0.950,0.970) and cervical (OR = 0.958, 95% CI: 0.950,0.966) screening participation, in cross-sectional analyses. Higher neuroticism scores were associated with reduced cervical screening participation, but the opposite was found for breast cancer screening. Examination of individual neuroticism items revealed that anxiety and worry were associated with increased breast screening. At follow-up, higher baseline depressive symptoms were related to decreased cervical screening (OR = 0.955, 95% CI: 0.913,0.999), but not with breast screening.


More severe depressive symptoms may be a barrier for breast and cervical screening and could be an indicator for more proactive strategies to improve uptake.


breast cancer; cancer; cervical cancer; depression; epidemiology; neuroticism; oncology; prevention; screening


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