Baseline Patient and Tumour Characteristics Associated with Mental Health in Men Undergoing Active Surveillance for Prostate Cancer.

OBJECTIVES

This study aims to examine how patient demographics and clinical characteristics relate to mental well-being in men with prostate cancer (PCa) on active surveillance (AS).

SUBJECTS AND

METHODS

We analysed data from the GAP3 database, established in 2014. The study included men from three cohorts who completed baseline self-reported well-being assessments using either the Memorial Anxiety Scale for Prostate Cancer (MAX-PC, n = 488) or the Functional Assessment of Cancer Therapy-Prostate Emotional Well-being Score (FACT-P EWB, n = 497). MAX-PC scores were categorised as mild (<9), moderate (9-27) or high anxiety (≥27), while FACT-P EWB scores were divided into tertiles (≤18, 19-20 and ≥21; higher scores indicate better emotional well-being). Descriptive statistics and ordinal logistic regression were used to examine associations between baseline characteristics and questionnaire scores.

RESULTS

Among the men across three cohorts, 488 completed the MAX-PC and 497 the FACT-P EWB. In the chi2 analysis for the MAX-PC cohort, anxiety levels were significantly associated with baseline BMI, ethnicity, marital status, education, family history of PCa, PSA levels, T stage, smoking status, Charlson Comorbidity Index and erectile dysfunction (all p < 0.001). Ordinal logistic regression showed that a family history of prostate cancer was associated with higher anxiety (OR = 1.94, 95% CI: 1.26-3.00). In contrast, no significant associations were observed in the FACT-P EWB cohort.

CONCLUSION

Our findings highlight several baseline demographic and clinical factors associated with disease-specific anxiety in men with PCa on AS. These results underscore the importance of routine psychosocial elements and of considering lifestyle and psychosocial factors when evaluating the supportive care needs of men considering or pursuing PCa AS.