Associations Between Self-Rated Health and Mortality in the Norwegian Women and Cancer (NOWAC) Study,2025, Killie et al

Abstract
Purpose
We investigated the association between self-rated health (SRH) and cancer incidence and SRH and all-cause mortality among Norwegian women.

Population and Methods
We used data from 110,104 women in the Norwegian Women and Cancer (NOWAC) cohort aged 41–70 years at baseline. We used flexible parametric survival analysis with restricted cubic splines to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between SRH and mortality in the entire cohort. We employed the same method in a multistate design to assess associations between baseline SRH and 1) cancer incidence, and 2) all-cause mortality in subgroups of women who did and did not receive a cancer diagnosis during follow-up.

Results
With very good SRH as reference category for all associations and median age at end of follow-up, lower SRH was associated with increased mortality (HRgood SRH 1.19, 95% CI 1.12–1.26) and HRpoor SRH 1.81, 95% CI 1.66–1.97). Lower SRH at baseline was associated with cancer incidence (HRgood SRH 1.14, 95% CI 1.08–1.20 and HRpoor SRH 1.44, 95% CI: 1.32–1.58). Poor baseline SRH was associated with increased mortality for women who received a cancer diagnosis (HRpoor SRH 1.20, 95% CI 1.04–1.39), and SRH showed a strong association with increased mortality for women who stayed cancer free (HRgood SRH 1.59, 95% CI 1.44–1.77 and HRpoor SRH 3.34, 95% CI 2.91–3.84).

Conclusion
Lower SRH at baseline predicted increased cancer risk and all-cause mortality in middle-aged to older women. Poor SRH at baseline predicted all-cause mortality in women who later received a cancer diagnosis. Both good and poor SRH at baseline predicted all-cause mortality in women who stayed cancer-free, and the association was stronger for these women compared to both the entire cohort and to women who were subsequently diagnosed with cancer.

LINK

 

People who self report poor health likely have poor health. Shocking to some, apparently

Forskning.no has an article about this study, where one of the take-aways is that patients who self report poor health may be noticing early signs of illness or have a high risk of illness.

LINK (In Norwegian, google translate won't let me create an already translated version)

The article also has links to studies with similar findings that self reported health is associated with illness and/or mortality later.

 

Of course a bajillion years of evolution has prepared us for the early intuitive, less overt and specific, warning signs of approaching health trouble.

It is bizarre to me that anybody would think otherwise, and devote their time to boldly declaring these alerts to be both a false foreboding, and yet somehow also the cause of the health troubles.

This is what happens when you don't discriminate adequately between correlation and causation, and reject falsification.