BACKGROUND: This study assessed the association between Type D personality (the 
conjoint effect of negative affectivity and social inhibition) and quality of 
life (QoL) and mental health of cancer survivors up to 10 years post-diagnosis.
METHODS: All currently alive individuals diagnosed with endometrial 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 a 
questionnaire on Type D personality (DS14), QoL (SF-36 or EORTC-QLQ-C30) and 
mental health (HADS).
RESULTS: Of the 3080 survivors who responded (69%), 572 (19%) had a Type D 
personality. Type D survivors had clinically meaningful lower levels of general 
health, social functioning, role-function emotional, mental health and vitality 
compared to non-Type D's (SF-36: all P's<0.001). They also reported clinically 
meaningful worse emotional and social functioning, global health status/QoL, and 
more fatigue (EORTC-QLQ-C30: all P's<0.001). This was also confirmed by 
multivariate logistic regression analyses showing that cancer survivors with a 
Type D personality were more likely to experience a decreased QoL on all SF-36 
and EORTC-QLQ-C30 scales (all ORs ranging between 1.88 and 5.56). The proportion 
of survivors reporting an impaired QoL was higher among Type D (35-64%) than 
non-Type D's (20-36%). Finally, Type D's were more likely to be depressed (44% 
vs. 13%; P<0.0001) or anxious (51% vs. 14%; P<0.0001).
CONCLUSIONS: Cancer survivors with a Type D personality are at increased risk of 
impaired QoL and mental health problems that cannot be explained by 
socio-demographic or clinical characteristics.