Abstract 3657: Mental health disorders among prostate cancer patients in a population-based cohort
Authors: Hu Siqi 
Published: June 2022

Abstract
Background. Prostate cancer is the most common malignancy among men in the United States. Few studies evaluate mental health disorders comprehensively among prostate cancer patients with long-term follow-up. The primary aim of our study is to assess the incidence of mental health disorders among prostate cancer patients compared to a general population cohort. A secondary aim is to investigate risk factors for mental health disorders among prostate cancer patients.
Methods. Cohorts of 18,134 cancer patients with prostate adenocarcinomas diagnosed between 2004 and 2017 and 73,470 men without cancer matched by age, birth state and follow up time from the general population were identified. Mental health diagnoses were identified from electronic medical records and statewide healthcare facilities data. Cox proportional hazard models were used to estimate hazard ratios (HRs).
Results. Prostate cancer patients had increased risks of mental illnesses for the first five years after cancer diagnosis (0-2 years: HR=1.81, 95%CI=1.75-1.87; 2-5 years: HR=1.05, 95%CI=1.01-1.08) compared to the general population, but not in the later follow up periods. Elevated risks of anxiety disorder among prostate cancer patients were observed during across follow-up periods (0-2 years: HR= 1.59, 95% CI= 1.49-1.70; 2-5 years: HR= 1.20, 95% CI= 1.12-1.28; 5-10 years: HR= 1.20, 95% CI= 1.12-1.29; 10- 16 years: HR= 1.29, 95% CI= 1.14-1.45). Likewise, mood disorders, including depressive disorders, among prostate cancer survivors were found for all follow-up periods (0-2 years: HR= 1.59, 95% CI= 1.50-1.69; 2-5 years: HR= 1.21, 95% CI= 1.14-1.29; 5-10 years: HR= 1.20, 95% CI= 1.13-1.28; 10-16 years: HR=1.25, 95% CI= 1.12-1.38).The risks of any mental illness were increased with PSA&gt;20ng/ml, high Gleason score, high-level risk group (intermediate, high, and very high), higher AJCC staging, and androgen deprivation treatment (ADT) therapy within 10 years after prostate cancer diagnosis. Surgery, radiation, ADT and tumor characteristics were also important risk factors for depression at 0-2 years after prostate cancer diagnosis. A baseline Charlson Comorbidity Index score of 1+ and unmarried status were associated with increased risk of any mental illness and depression across all time periods. We also observed that increased risks of any mental illness were associated with Hispanic, black or multiple races, underweight or obese, and family history of prostate cancer for all time periods. Prostate cancer survivors had a 26% increased risk of death associated with a mental illness diagnosis and a 61% increased risk of death with a depression diagnosis.
Conclusion. Prostate cancer diagnosis is associated with poor mental health, which was observed as long as 16 years after cancer diagnosis. Providing long-term mental health support may be potentially beneficial to increasing life expectancy for prostate cancer patients.
Citation Format: Siqi Hu. Mental health disorders among prostate cancer patients in a population-based cohort [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3657.