Department of Oncology, Copenhagen University Hospital, Rigshospitalet, 2100, Copenhagen, Denmark.
Department of Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark.
J Cancer Surviv. 2020 Feb;14(1):72-79. doi: 10.1007/s11764-019-00835-0. Epub 2019 Nov 21.
Long-term cancer survivors may develop psychological late effects. The aim of the present study was to determine prevalence of high level of stress in testicular cancer survivors (TCS) compared with the general population and prevalence of high level of stress among TCS stratified by type of treatment (surveillance, bleomycin, etoposide and cisplatin (BEP), or abdominal radiotherapy (RT)).
In this large, nationwide and population-based, cross-sectional study, a total of 2252 TCS filled in a questionnaire between 2014-2016 covering psychological stress (Perceived Stress Scale (PSS)), sociodemographic factors, and physical health variables. Results were compared with a reference population. The reference population consisted of 61,927 men without prior or present cancer and sampled at random from the central population. High level of stress was defined as a PSS score ≥ 16, equivalent to the highest scoring quintile in the reference population. Logistic regression models adjusted for relevant covariates were used to estimate prevalence ratios of high level of stress.
Distribution of TCS was: surveillance, n = 1134; BEP, n = 807; and RT, n = 311 (median time since diagnosis was 19 years). TCS were more likely to have high level of stress compared to the reference population with a prevalence ratio of 1.56 (95% CI, 1.40-1.73). Individually, surveillance, BEP and RT groups had higher level of stress compared to the reference population.
TCS are more likely to have high level of stress. Screening programs for psychological stress should be considered as part of the follow-up program.
A higher level of stress is observed in TCS irrespective of treatment.
长期癌症幸存者可能会出现心理晚期效应。本研究旨在确定与普通人群相比，睾丸癌幸存者（TCS）的高压力水平的患病率，并根据治疗类型（监测、博来霉素、依托泊苷和顺铂（BEP）或腹部放疗（RT））对 TCS 中高压力水平的患病率进行分层。
在这项大型的、全国性的、基于人群的横断面研究中，共有 2252 名 TCS 在 2014-2016 年间填写了一份问卷，内容包括心理压力（感知压力量表（PSS））、社会人口统计学因素和身体健康变量。结果与参考人群进行了比较。参考人群由 61927 名无既往或现有癌症且随机抽样自中心人群的男性组成。高压力水平定义为 PSS 评分≥16，相当于参考人群中得分最高的五分位数。使用调整了相关协变量的逻辑回归模型来估计高压力水平的患病率比。
TCS 的分布为：监测组，n=1134；BEP 组，n=807；和 RT 组，n=311（中位诊断后时间为 19 年）。与参考人群相比，TCS 更有可能出现高水平的压力，患病率比为 1.56（95%CI，1.40-1.73）。单独来看，监测组、BEP 组和 RT 组与参考人群相比压力水平更高。
TCS 更有可能出现高水平的压力。应考虑将心理压力筛查计划作为随访计划的一部分。
无论治疗方式如何，TCS 都观察到更高水平的压力。
