Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada,
Department of Urology, Dalhousie University, Halifax, Nova Scotia, Canada,
Oncology. 2021;99(4):260-270. doi: 10.1159/000512444. Epub 2021 Jan 22.
Prostate and skin cancer are among the most prevalent forms of cancer among men and have favorable survival rates compared to other, more aggressive forms of cancers. Recent studies have shown that the odds of depression among men with a lifetime history of prostate cancer are higher compared to men without a lifetime history of prostate cancer. Here we extend previous findings and examine the role of socioeconomic status in the relationship between depression and cancer survivorship status in a population-based sample of men from Atlantic Canada.
A cross-sectional analysis was conducted on a subsample of 6,585 male participants aged 49-69 years from the 2009-2015 survey cycle of the Atlantic PATH study. The primary outcome was screening positive for mild, moderate or severe depression using the Patient Health Questionnaire (PHQ-9). The main predictor variable was cancer survivorship status (the presence of a lifetime history of prostate cancer, skin cancer, forms of cancer other than prostate or skin cancer, or absence of a lifetime cancer diagnosis). Covariates included age, education, marital status, household income, province, ethnicity, comorbidity, and survivorship time.
An estimated 14.7% of men in this sample screened positive for mild, moderate or severe depression. Men with a history of prostate cancer were 2.60 (95% CI: 1.02, 6.65) times more likely to screen positive for depression than men with a history of any other form of cancer. The odds ratios were 10.23 (95% CI: 2.82, 37.49) or 4.00 (95% CI: 1.20, 13.34) times higher for survivors of prostate or skin cancer who reported a low household income to screen positive for depression compared to men with a history of any other form of cancer and high household income.
These results extend current evidence of the association between prostate cancer survivorship and depression compared with men who never had a history of cancer diagnosis by indicating that this association still stands when the survivors of prostate cancer are compared to survivors of any other form of cancer, and further indicates that this association is moderated by household income. The findings highlight the importance of delivering mental health screening and support to prostate cancer survivors during the cancer journey, especially those with low household incomes.
前列腺癌和皮肤癌是男性中最常见的癌症类型之一，与其他侵袭性更强的癌症相比，其生存率较高。最近的研究表明，与没有前列腺癌病史的男性相比，有前列腺癌病史的男性患抑郁症的几率更高。在这里，我们扩展了之前的研究结果，并在加拿大大西洋地区的男性人群中基于人群的样本中，研究了社会经济地位在抑郁症与癌症生存状态之间关系中的作用。
对来自大西洋 PATH 研究 2009-2015 年调查周期的 6585 名 49-69 岁男性的亚样本进行了横断面分析。主要结果是使用患者健康问卷（PHQ-9）筛查出轻度、中度或重度抑郁。主要预测变量是癌症生存状态（是否有前列腺癌、皮肤癌、除前列腺癌或皮肤癌以外的癌症形式的终生病史，或无终生癌症诊断）。协变量包括年龄、教育程度、婚姻状况、家庭收入、省份、种族、合并症和生存时间。
在该样本中，估计有 14.7%的男性筛查出轻度、中度或重度抑郁。有前列腺癌病史的男性患抑郁症的几率是有其他任何形式癌症病史的男性的 2.60 倍（95%CI：1.02，6.65）。前列腺癌或皮肤癌幸存者报告家庭收入较低时，患抑郁症的几率分别是有其他任何形式癌症病史和家庭收入较高的男性的 10.23 倍（95%CI：2.82，37.49）或 4.00 倍（95%CI：1.20，13.34）。
这些结果扩展了当前关于前列腺癌生存状态与抑郁症之间关联的证据，与从未有过癌症诊断史的男性相比，前列腺癌生存者的这种关联仍然存在，而且进一步表明，这种关联受到家庭收入的调节。这些发现强调了在癌症治疗过程中为前列腺癌幸存者提供心理健康筛查和支持的重要性，尤其是那些家庭收入较低的患者。
