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New-onset Depression and Mental Health-Related Quality of Life Following Prostate Cancer Diagnosis Without Treatment

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Sources of Funding: Emory Urology Research Scholars Grant_x000D_ Winship Cancer Institute Prostate Cancer Pilot Grant

Introduction

To examine if men receiving a prostate cancer diagnosis without evidence of treatment had increased risk of new-onset depression and changes in mental health-related quality of life (HRQOL).

Methods

Using Surveillance, Epidemiology, and End Results - Medicare Health Outcomes Survey (SEER-MHOS) data (2006-2013), we identified localized prostate cancer patients who completed baseline and follow-up HRQOL surveys before/after their cancer diagnosis and were not treated in the interim. Surveys captured major depressive disorder and mental component scores (MCS) of the Veterans RAND 12-item health survey, where higher scores correspond to greater HRQOL. The cohort was divided into 3 subgroups of cases by time between diagnosis and follow-up: <1, 1-3, and >3 years. Cases were matched to controls based on age, marital status, and time between surveys. Bivariate statistics (i.e., Kruskal-Wallis and chi-square tests) were used to evaluate the relationship between incident prostate cancer diagnosis and (a) development of new-onset depression and (b) changes in MCS.

Results

We identified 221 cases matched to 221 controls (n=126 < 1 yr from diagnosis to follow-up, n=82 1-3 yr, n=13 >3 yr). Mean age for subgroups were 75.4 (< 1 yr f/u), 76.6 (1-3 yr f/u), and 78.2 years (>3 yr f/u). Compared to controls, new-onset depression was not more common among prostate cancer patients followed for 1 yr (11.1% vs 8.3% controls, p= 0.53) but was more common if followed for 1-3 yr (14.6% vs 4.9% controls, p=0.04) after diagnosis. Changes in MCS were not significantly greater for cases compared to controls within 1 yr (-0.1 vs -1.4 control, p=0.27) and from 1-3 yr (-2.5 vs -1.0, p=0.54) (Figure). Among men with <1 yr follow-up, new-onset depression was associated with significant decreases in mental HRQOL (-7.0 vs 0.1 no depression, p=0.0038). However, changes were not more significant for prostate cancer patients compared to controls (-3.0 vs -12.1 controls, p=0.15).

Conclusions

Though more likely to screen positive for new-onset depression, men diagnosed with prostate cancer not receiving treatment did not experience significant changes in overall mental health-related quality of life over time, compared to men without a prostate cancer diagnosis. _x000D_

Funding

Emory Urology Research Scholars Grant_x000D_ Winship Cancer Institute Prostate Cancer Pilot Grant

Authors
Hankyul Kim
Dattatraya Patil
Christopher Filson
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