Long-Term Mental Health Outcomes in Prostate Cancer Survivors and Their Partners

前列腺癌幸存者及其伴侣的长期心理健康结果

• 批准号: 10416343
• 负责人: Casey Crump
• 金额: $ 56.43万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-21 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10416343
• 关键词: Address; Alcohol consumption; Anxiety; Birth; Cancer Patient; Cancer Survivor; Cancer Survivorship; Caring; Cause of Death; Cessation of life; Characteristics; Clinical; Country; Data; Diagnosis; Disease; Distress; Drug Use Disorder; Early Intervention; Education; Educational workshop; Health; Hospitals; Incidence; Income; Individual; Inpatients; Intervention; Knowledge; Long-Term Care; Longitudinal Studies; Major Depressive Disorder; Malignant Neoplasms; Malignant neoplasm of prostate; Marital Status; Mental Depression; Mental Health; Mental disorders; Military Personnel; Modeling; Operative Surgical Procedures; Outcome; Outpatients; Patients; Persons; Population; Primary Health Care; Prostate Cancer therapy; Psyche structure; Public Health; Quality of life; Radiation; Registries; Relative Risks; Research; Risk; Sample Size; Self Care; Sexual Dysfunction; Spouses; Stress; Subgroup; Suicide; Suicide attempt; Sweden; Testing; Time; United States National Institutes of Health; Urinary Incontinence; Vulnerable Populations; cancer diagnosis; cancer survival; cancer therapy; care outcomes; caregiving; cohort; cost; cost efficient; follow-up; high risk; improved; innovation; medical specialties; men; mortality; population based; premature; prevent; prostate cancer survivors; psychosocial; racial and ethnic; side effect; stress resilience; suicidal morbidity; tumor

Prostate cancer (PC) is the most commonly diagnosed cancer among men in the US and in most countries worldwide. Over 3.6 million US men are currently living with PC, and this number is expected to increase to >5 million by 2030. Approximately 90% of PC cases are diagnosed at a local or regional stage, when the 5-year survival is >99%. Consequently, most men with PC survive >15-20 years after diagnosis. However, PC diagnosis and treatment can be devastating for men and their partners, and may increase risks of mental illness. Importantly, mental disorders are treatable, and early intervention could reduce suffering, improve quality of life, and prevent premature death. Despite the high public health burden of mental disorders, they are severely understudied compared with somatic outcomes of PC. A comprehensive understanding of long- term mental health sequelae is critically needed to improve care and outcomes for PC survivors and their partners. The few prior studies have had important limitations, including limited follow-up times and sample sizes, and ascertainment of mental disorders using only hospital data, which captures only the most severe cases. No large-scale studies have included partners. We will address these limitations by conducting the first comprehensive long-term study of mental health outcomes in PC survivors and partners in a national cohort (N >4 M) using highly complete data from primary care, specialty outpatient, and inpatient settings. We hypothesize that PC survivors and their partners have increased risks of major mental disorders and suicide. To test this hypothesis, we will examine these outcomes in 210,432 men diagnosed with PC in Sweden in 1987-2018 and their 163,085 partners, compared with 2.1 M men without PC and their 1.6 M partners, followed for up to 34 years through 2020. Sweden is an ideal setting because individual-level data an PC diagnoses, treatment, and mental health outcomes are available for the entire population with over 3 decades of follow-up, and the incidence and treatment of PC and common mental disorders are comparable to the US. This proposal addresses key priorities identified by the 2019 NCI workshop on "Evidence Gaps in Cancer Survivorship Care". Our specific aims are to identify: (1) long-term risks of 4 mental disorders (major depression, anxiety, alcohol and drug use disorders) and suicide in PC survivors; (2) high-risk subgroups who may benefit most from interventions; (3) whether mental disorders are associated with higher PC-specific mortality; and (4) long-term risks of mental disorders and suicide in partners of PC survivors. The proposed research is significant because millions of men are surviving with PC, and their mental health sequelae may have substantial impacts that are understudied and preventable. It is innovative because it will provide the first long-term assessment in a national cohort of PC survivors and partners by integrating unparalleled individual- level data for >4 M people. The results will identify the long-term mental health outcomes in PC survivors, their partners, and high-risk subgroups, and guide early interventions to improve their long-term health.

前列腺癌(PC)是美国和大多数国家最常见的男性癌症 全世界。目前有超过360万美国男性患有电脑，预计这一数字将增加到5 到2030年将达到100万。大约90%的PC病例是在当地或地区阶段诊断出来的，当时5年 存活率为99%。因此，大多数患有PC的男性在确诊后存活15-20年。然而，PC 诊断和治疗对男性和他们的伴侣来说是毁灭性的，并可能增加精神疾病的风险 生病了。重要的是，精神障碍是可以治疗的，早期干预可以减少痛苦，改善 提高生活质量，防止过早死亡。尽管精神障碍给公共卫生造成了沉重的负担，但他们 与PC的躯体结局相比，研究严重不足。全面认识龙-- 长期精神健康后遗症是迫切需要的，以改善对PC幸存者及其患者的护理和预后 合伙人。少数先前的研究有重要的局限性，包括有限的跟踪时间和样本 大小，以及仅使用医院数据确定精神障碍，这些数据仅捕获最严重的 案子。没有大规模的研究将伴侣包括在内。我们将通过进行第一个 关于国家队列中精神分裂症幸存者和伴侣的心理健康结果的综合长期研究(N &gt；4 M)使用来自初级保健、专科门诊和住院设置的高度完整的数据。我们 假设PC幸存者和他们的伴侣有更多的严重精神障碍和自杀风险。 为了验证这一假设，我们将于年在瑞典检查210,432名被诊断为PC的男性的这些结果。 1987-2018年和他们的163,085名伴侣紧随其后，相比之下，210万没有电脑的男性和他们的160万伴侣紧随其后 到2020年，最长可达34年。瑞典是一个理想的环境，因为个人级别的数据由PC诊断， 经过30多年的随访，所有人都可以获得治疗和心理健康结果， 而PC和常见精神障碍的发病率和治疗与美国相当。这 该提案涉及2019年NCI研讨会确定的关键优先事项，该研讨会的主题是“癌症中的证据差距” 生存护理“。我们的具体目标是确定：(1)4种精神障碍的长期风险(主要 抑郁、焦虑、酒精和药物使用障碍)和自杀；(2)高危亚组 可能从干预中获益最多；(3)精神障碍是否与较高的PC专一性有关 死亡率；以及(4)PC幸存者的伴侣精神障碍和自杀的长期风险。建议数 研究意义重大，因为数以百万计的男性与电脑一起生存，他们的心理健康后遗症可能 造成未得到充分研究和可预防的重大影响。它是创新的，因为它将提供第一个 在全国PC幸存者和合作伙伴队列中进行长期评估，方法是整合无与伦比的个人- &gt；400万人的级别数据。这一结果将确定PC幸存者的长期心理健康结果，他们的 并指导早期干预措施以改善他们的长期健康状况。