Mental health and sleep in cancer prevention - removing barriers to health.

AIM: The aim of this review is to summarize current evidence on the relationship between mental health, stress, sleep, and cancer prevention, and to propose a clinically applicable framework for integrating these topics into preventive practice without attributing a direct causal role in cancer development. MATERIAL AND METHODS: This narrative review is based on epidemiological, clinical, and meta-analytic studies examining mental health, sleep disturbances, and their associations with cancer risk, health-related behavior, and prevention. Relevant psycho-oncological and preventive care recommendations are also considered. RESULTS: Available evidence does not support mental disorders or sleep disturbances as direct causes of cancer. Their clinical relevance lies primarily in indirect pathways, particularly through health-related behavior, adherence to preventive recommendations, and the capacity to cope with long-term burden. Sleep disturbances additionally represent a modifiable risk factor for the development of several mental disorders, which may further influence preventive behavior. Psycho-oncological screening and a stepped--care approach to mental health support enable early identification of barriers to prevention with minimal burden on clinical practice. CONCLUSION: Mental health and sleep should be conceptualised as regulatory conditions of cancer prevention rather than causal factors. Translating scientific evidence into clear and clinically meaningful language, and incorporating it sensitively into physician-patient communication, is essential for their effective use in preventive care.