Abstract
Background: Small-scale studies indicate an increase in mental health disorders among prostate cancer survivors compared to the general population, but large population-based data assessing this relationship are scarce. The present study examined the prevalence of lifetime history of prostate cancer in a cross-sectional sample of Canadian men and assessed the contribution of lifetime history of a prostate cancer diagnosis, multimorbidity, and current alcohol and smoking status to the association with current mental health outcomes in this population.Methods: The analytical sample included 25,183 men (aged 45 to 85 years old), who completed a survey as part of the Canadian Longitudinal Study on Aging (CLSA). The Center for Epidemiological Studies Depression Scale (CES-D10), Kessler's Psychological Distress Scale (K10), and self-reported mental health were mental health outcomes. Multiple logistic regression analyses, and controlling for the complexity of the design and covariates, evaluated the association between prostate cancer survivorship, multimorbidity, alcohol and smoking status, and current mental health outcomes.Results: The prevalence of lifetime history of prostate cancer diagnosis in this population-based sample of men was 4% (95% CI: 3.7, 4.4). Our results indicate statistically significantly higher odds of current psychological distress (aOR = 1.52, 95% CI: 1.09, 2.11) and screening positive for depression (aOR = 1.24; 95% CI: 1.02, 1.51) among survivors of prostate cancer, compared to men without a history of prostate cancer diagnosis in demographics controlled analyses. After addition of multimorbidity and substance use, the odds of screening positive for depression among survivors of prostate cancer are 1.32 (95% CI: 1.06, 1.64) higher compared to men who never had a history of prostate cancer diagnosis.Interpretation: Patient education and empowerment programs aimed at addressing concerns during the diagnosis and treatment and enhancing survivorship care plans by adding routine screening for mental distress to help survivors overcome poor mental health during the cancer survivorship journey, are warranted.
Highlights
Prostate cancer (PCa) is the most commonly diagnosed cancer among men in Canada, Europe, and the USA [1, 2]
The results indicate higher odds (OR = 1.20; 95% CI: 1.04, 1.39) of lifetime history of PCa among married men compared to single men, and among men older than 65 years old (OR = 5.03, 95% CI: 4.27, 5.93, and OR = 9.50 95% CI: 8.11, 11.07 times higher for men between 65 and 75 years old, or older than 75, respectively) compared to men younger than 65 years old
Odds for lifetime history of PCa were almost double (OR = 1.80; 95% CI: 1.23, 2.65) among PEI residents compared to Alberta residents, overall, province of residence was not statistically significantly associated with lifetime history of PCa diagnosis status
Summary
Prostate cancer (PCa) is the most commonly diagnosed cancer among men in Canada, Europe, and the USA [1, 2]. While treatment for highrisk PCa patients, especially for healthy younger men, usually is treated with open surgery, laparoscopic or robotic-assisted laparoscopic surgery, which includes the removal of the prostate gland, moderate to low-risk PCa may be treated with radiation and hormonal therapy [2, 3]. These treatments have improved considerably over the decades and are providing very good curative results [2,3,4]. The present study examined the prevalence of lifetime history of prostate cancer in a cross-sectional sample of Canadian men and assessed the contribution of lifetime history of a prostate cancer diagnosis, multimorbidity, and current alcohol and smoking status to the association with current mental health outcomes in this population
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