Mental Health Burden of a Testicular Cancer Diagnosis: Insights From a Large Claims Database.

OBJECTIVE

To evaluate the mental health outcomes of patients with testicular cancer (TC) and identify the relative risk of mental health diagnoses following TC diagnosis compared to a control population without TC.

MATERIALS AND

METHODS

The TriNetX Diamond network database was queried for men between 15 and 45 years undergoing radical orchiectomy for TC and compared to an age-matched control group of men who underwent an orchiectomy for testicular torsion. Patients with history of mental health disorders, with nodal/metastatic disease, and patients who underwent chemotherapy, radiotherapy, or RPLND were excluded. A 1:1 propensity score matching was performed to compare the prevalence of newly diagnosed anxiety disorders, sleep disorders, and depressive episodes anytime following orchiectomy.

RESULTS

A total of 9264 males underwent an orchiectomy. After matching for age, race, and use of antidepressants/antipsychotics, 2178 men were included (1089 radical and 1089 simple orchiectomies). After propensity score matching, patients with TC had significantly higher rates of newly diagnosed depression (8.4% vs 3.1%; P <.01), anxiety (17.6% vs 7.1%; P <.01), and sleep disorders (9.0% vs 3.6%; P <.01) compared to patients undergoing simple orchiectomy. Patients diagnosed with TC had a 2.7-fold higher relative risk of developing depression, 2.5-fold higher risk of anxiety, and 2.5-fold higher risk of sleep disorders compared to the control population.

CONCLUSION

Receiving a TC diagnosis was associated with greater prevalence of newly diagnosed anxiety, sleep disorders, and depression. These findings indicate that the cancer diagnosis itself, rather than the orchiectomy, is likely a driver of mental health disorders in this young patient group.