HEOR Modeling and Advanced Analytics, Parexel International, Durham, NC, USA.
Department of Health Policy and Management, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Cancer Med. 2020 Jun;9(12):4467-4473. doi: 10.1002/cam4.3069. Epub 2020 Apr 23.
There are uncertainties about prostate cancer-related anxiety's (PCRA) associations with health-related quality of life (HRQOL) and major depression, and these could affect the quality of mental healthcare provided to prostate cancer patients. Addressing these uncertainties will provide more insight into PCRA and inform further research on the value of PCRA prevention. The goals of this study were to measure associations between PCRA and HRQOL at domain and subdomain levels, and to evaluate the association between PCRA and probable (ie, predicted major) depression.
We analyzed secondary cross-sectional data from the North Carolina Prostate Cancer Comparative Effectiveness & Survivorship Study (NC ProCESS-a population-based cohort of prostate cancer patients enrolled shortly after diagnosis [between January 2011 and June 2013] and followed prospectively). Patient-reported measures of PCRA and HRQOL from 1,016 enrollees who participated in NC ProCESS's 1-year follow-up survey were assessed. Outcomes of interests were a) linear correlations between contemporaneous memorial anxiety scale for prostate cancer (MAX-PC) and Short Form 12 (SF-12) scores, and b) measures of association between indicators of clinically significant PCRA (ie, MAX-PC > 27) and probable depression during survey contact (ie, SF-12 mental component score ≤43).
PCRA measures had notable associations with SF-12's mental health subscale (assesses low mood/nervousness [rho = -0.42]) and emotional role functioning subscale (assesses subjective productivity loss [rho = -0.46]). Additionally, the risk of probable depression was significantly higher in participants with clinically significant PCRA compared with those without it (weighed risk ratio = 5.3, 95% confidence interval 3.6-7.8; P < .001).
Prostate cancer patients with clinically significant PCRA should be assessed for major depression and productivity loss.
前列腺癌相关焦虑（PCRA）与健康相关生活质量（HRQOL）和重度抑郁症之间的关联存在不确定性，这些不确定性可能会影响为前列腺癌患者提供的心理健康护理质量。解决这些不确定性将更深入地了解 PCRA，并为进一步研究 PCRA 预防的价值提供信息。本研究的目的是测量 PCRA 与 HRQOL 各领域和子领域之间的关联，并评估 PCRA 与可能（即预测的主要）抑郁症之间的关联。
我们分析了北卡罗来纳前列腺癌比较效果和生存研究（NC ProCESS-一个基于人群的前列腺癌患者队列，在诊断后不久（2011 年 1 月至 2013 年 6 月期间）招募并进行前瞻性随访）的二次横断面数据。来自 1016 名参加 NC ProCESS 1 年随访调查的参与者的患者报告的 PCRA 和 HRQOL 测量结果进行了评估。感兴趣的结果是：a）同期记忆前列腺癌焦虑量表（MAX-PC）和健康调查简表 12 项（SF-12）得分之间的线性相关性，b）指标之间的关联测量具有临床意义的 PCRA（即 MAX-PC > 27）和调查期间的可能抑郁症（即 SF-12 心理成分得分≤43）。
PCRA 测量与 SF-12 的心理健康子量表（评估情绪低落/紧张感[rho =-0.42]）和情绪角色功能子量表（评估主观生产力损失[rho =-0.46]）有显著关联。此外，与无临床意义 PCRA 的参与者相比，具有临床意义的 PCRA 的参与者发生可能抑郁症的风险显著更高（加权风险比=5.3，95%置信区间 3.6-7.8；P<.001）。
应评估具有临床意义的 PCRA 的前列腺癌患者是否患有重度抑郁症和生产力损失。
