Journal of cancer survivorship : research and practice · 2026
Association between prostate cancer and mental health: a comparison across cancer types using the medical expenditure panel survey, 2017-2022.
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Malshy Kamil, Jia Yusheng, Zhu Denzel, Sun Melody, Shin Jaeuk, Steidle Matthew, Li Ashley, Hunt Trevor C, Guo Wenhan, Bandari Jathin, Cheng Zijing
Аннотация
BACKGROUND: To evaluate whether men with prostate cancer (PCa) experience better mental health outcomes than those with other major cancers, using nationally representative data.
METHODS: We conducted a repeated cross-sectional study using Medical Expenditure Panel Survey Household Component data (2017-2022). Respondents were categorized as having no history of cancer, PCa, or non-prostate cancer (non-PCa). The primary outcome was fair/poor self-rated mental health. Secondary outcomes included major depressive symptoms (PHQ-2 ≥ 3) and serious psychological distress (K6 ≥ 13). Multivariable logistic regression was employed to estimate adjusted odds ratios (aORs) with 95% confidence intervals, controlling for sociodemographic and health-related covariates.
RESULTS: Among 31,706 respondent-year observations, 41.0% reported fair or poor mental health (40.4% among those with no cancer history, 42.1% with PCa, and 47.2% with non-PCa cancers; p < 0.001). In adjusted analyses, non-PCa was associated with higher odds of fair/poor mental health compared to PCa (aOR = 1.24, 95% CI: 1.05-1.46). Depression and distress rates were low across all groups (e.g., 7.3% and 3.0% in PCa, respectively), and did not differ significantly by cancer history. Exploratory analyses revealed significant variations by specific cancer type, including higher odds of fair/poor mental health (aOR = 1.37; p=0.03) but lower odds of serious psychological distress (aOR = 0.12; p=0.035) among colon cancer survivors compared to PCa survivors.
CONCLUSIONS: Self-rated mental health among men with PCa was comparable to individuals with no history of cancer and more favorable than among those with non-PCa malignancies. However, nearly 40% of PCa patients still reported mental health below "good," supporting the need for continued psychosocial support across cancer survivorship populations.
IMPLICATIONS FOR CANCER SURVIVORS: While men with PCa demonstrate more favorable mental health profiles than those with other cancers, nearly 40% report mental health status below good. These findings suggest that concerns regarding psychological distress remains highly relevant in survivorship care, including for cancers with highly favorable prognoses.
METHODS: We conducted a repeated cross-sectional study using Medical Expenditure Panel Survey Household Component data (2017-2022). Respondents were categorized as having no history of cancer, PCa, or non-prostate cancer (non-PCa). The primary outcome was fair/poor self-rated mental health. Secondary outcomes included major depressive symptoms (PHQ-2 ≥ 3) and serious psychological distress (K6 ≥ 13). Multivariable logistic regression was employed to estimate adjusted odds ratios (aORs) with 95% confidence intervals, controlling for sociodemographic and health-related covariates.
RESULTS: Among 31,706 respondent-year observations, 41.0% reported fair or poor mental health (40.4% among those with no cancer history, 42.1% with PCa, and 47.2% with non-PCa cancers; p < 0.001). In adjusted analyses, non-PCa was associated with higher odds of fair/poor mental health compared to PCa (aOR = 1.24, 95% CI: 1.05-1.46). Depression and distress rates were low across all groups (e.g., 7.3% and 3.0% in PCa, respectively), and did not differ significantly by cancer history. Exploratory analyses revealed significant variations by specific cancer type, including higher odds of fair/poor mental health (aOR = 1.37; p=0.03) but lower odds of serious psychological distress (aOR = 0.12; p=0.035) among colon cancer survivors compared to PCa survivors.
CONCLUSIONS: Self-rated mental health among men with PCa was comparable to individuals with no history of cancer and more favorable than among those with non-PCa malignancies. However, nearly 40% of PCa patients still reported mental health below "good," supporting the need for continued psychosocial support across cancer survivorship populations.
IMPLICATIONS FOR CANCER SURVIVORS: While men with PCa demonstrate more favorable mental health profiles than those with other cancers, nearly 40% report mental health status below good. These findings suggest that concerns regarding psychological distress remains highly relevant in survivorship care, including for cancers with highly favorable prognoses.