OBJECTIVE: Cancer survivors often report comorbid diseases, but there are 
individual differences in risk. Type D personality is a general propensity to 
psychological distress that is related to poor cardiovascular outcomes. In this 
study, we examined whether type D was also related to comorbidity burden and 
health care utilization among cancer survivors.
METHODS: Individuals diagnosed with endometrial cancer or colorectal cancer 
between 1998 and 2007, or with lymphoma or multiple myeloma between 1999 and 
2008 as registered in the Eindhoven Cancer Registry, received the 
Self-Administered Comorbidity Questionnaire, questions on health care 
utilization and the Type D personality scale; 69% (n=3080) responded.
RESULTS: Nineteen percent of survivors had a type D personality. Over a 12-month 
period, type D survivors significantly more often reported osteoarthritis, back 
pain, and depression than non-type D survivors. Also, type D survivors more 
often reported to feel bothered by high blood pressure, osteoarthritis, heart 
disease, depression, diabetes and lung disease during daily activities. Type D 
survivors more often visited their general practitioner than non-type D 
survivors (P<.001), also in relation to cancer (0 visits: 54% vs. 60%; 1-5: 28% 
vs. 22%; >5: 9% vs. 5%; P<.001), as well as their specialist (0 visits: 6% vs. 
7%; 1-5 visits: 59% vs. 64%; >5 visits: 30% vs. 23%; P<.01).
CONCLUSION: Type D personality is a vulnerability factor that may help to 
identify subgroups of cancer survivors who are at an increased risk for 
comorbidity burden and increased health care utilization.