Purpose:While the mental health impact of a prostate cancer diagnosis,including low-risk prostate cancer,is well-documented,the effect of pre-existing anxiety and/or depression on adherence to active surveillance prot...Purpose:While the mental health impact of a prostate cancer diagnosis,including low-risk prostate cancer,is well-documented,the effect of pre-existing anxiety and/or depression on adherence to active surveillance protocols in low-risk prostate cancer patients remains unclear.This study assessed the association between prior anxiety and/or depression and active surveillance adherence in men with low-risk prostate cancer.Methods:We conducted a retrospective,multicenter study involving 426 men diagnosed with low-risk prostate cancer who were recommended active surveillance as the primary management strategy.Active surveillance adherence was defined by completion of both a prostate-specific antigen test and a prostate biopsy within 18 months of diagnosis.Premature treatment was identified as definitive treatment,either through radiation therapy or radical prostatectomy.Results:Men with a prior mental health diagnosis were significantly less likely to adhere to active surveillance than those without such a diagnosis(27.6%vs.49.5%,p=0.006).These individuals had lower adherence rates for prostate-specific testing(58.6%vs.73.4%)and biopsy(27.6%vs.50.0%)and were more likely to abandon active surveillance in favor of immediate treatment(39.7%vs.25.0%,p=0.005).No significant differences were observed between patients with both anxiety and depression versus those with a single diagnosis.Conclusions:Pre-existing anxiety and/or depression is associated with reduced active surveillance adherence and a greater likelihood of premature treatment in men with low-risk prostate cancer.These findings highlight the importance of addressing psychiatric factors in lowrisk prostate cancer management and suggest avenues for future research.展开更多
文摘Purpose:While the mental health impact of a prostate cancer diagnosis,including low-risk prostate cancer,is well-documented,the effect of pre-existing anxiety and/or depression on adherence to active surveillance protocols in low-risk prostate cancer patients remains unclear.This study assessed the association between prior anxiety and/or depression and active surveillance adherence in men with low-risk prostate cancer.Methods:We conducted a retrospective,multicenter study involving 426 men diagnosed with low-risk prostate cancer who were recommended active surveillance as the primary management strategy.Active surveillance adherence was defined by completion of both a prostate-specific antigen test and a prostate biopsy within 18 months of diagnosis.Premature treatment was identified as definitive treatment,either through radiation therapy or radical prostatectomy.Results:Men with a prior mental health diagnosis were significantly less likely to adhere to active surveillance than those without such a diagnosis(27.6%vs.49.5%,p=0.006).These individuals had lower adherence rates for prostate-specific testing(58.6%vs.73.4%)and biopsy(27.6%vs.50.0%)and were more likely to abandon active surveillance in favor of immediate treatment(39.7%vs.25.0%,p=0.005).No significant differences were observed between patients with both anxiety and depression versus those with a single diagnosis.Conclusions:Pre-existing anxiety and/or depression is associated with reduced active surveillance adherence and a greater likelihood of premature treatment in men with low-risk prostate cancer.These findings highlight the importance of addressing psychiatric factors in lowrisk prostate cancer management and suggest avenues for future research.
