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: 10650842
• 负责人: Casey Crump
• 金额: $ 14.11万
• 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 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10650842
• 关键词: Address; Anxiety; Birth; Cancer Patient; Cancer Survivorship; Caring; Cause of Death; Cessation of life; Characteristics; Clinical; Country; Data; Diagnosis; Disease; Distress; Drug Use Disorder; Early Intervention; Education; Educational workshop; Ethnic Origin; 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; Predisposition; Primary Care; Prostate Cancer therapy; Public Health; Quality of life; Race; Radiation; Registries; Relative Risks; Research; Risk; Risk Assessment; 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; alcohol use disorder; cancer diagnosis; cancer survival; cancer therapy; caregiving; cohort; cost; cost efficient; follow-up; high risk; improved; innovation; medical specialties; men; mortality; population based; premature; prevent; prostate cancer survivors; psychosocial; side effect; stress resilience; 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中最常见的癌症 全世界。目前有超过360万美国男性居住在PC中，预计这一数字将增加到> 5 到2030年，百万到2030年。当地或区域阶段，大约90％的PC病例被诊断出 生存率> 99％。因此，诊断后大多数PC的男性生存> 15 - 20年。但是，PC 诊断和治疗对男人及其伴侣可能是毁灭性的，并且可能会增加心理风险 疾病。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 生活质量，并防止过早死亡。尽管精神障碍的公共卫生负担很高，但 与PC的体细胞结局相比，严重研究了。对长期的全面理解 迫切需要一项心理健康后遗症，以改善PC幸存者及其的护理和结果 合作伙伴。少数先前的研究具有重要的局限性，包括随访时间和样本有限 尺寸，以及仅使用医院数据来确定精神障碍，这仅捕获最严重的 案例。没有大规模研究包括合作伙伴。我们将通过第一个来解决这些限制 全面研究PC幸存者和国家队列中PC幸存者和合作伙伴的心理健康成果的全面研究（n > 4 m）使用来自初级保健，专业门诊和住院设置的高度完整数据。我们 假设PC幸存者及其伴侣会增加严重精神障碍和自杀的风险。 为了检验这一假设，我们将在210,432名被诊断为瑞典诊断为PC的男性中检查这些结果 1987- 2018年及其163,085个合作伙伴，而没有PC的2.1 M男士及其1.6 M合作伙伴随后 到2020年，最多34年。瑞典是理想的环境 治疗和心理健康成果可用于整个人群，并进行了30多年的随访， PC和常见精神障碍的发病率和治疗与美国相当。这 提案解决了2019年NCI研讨会确定的有关癌症证据差距的关键优先事项 生存护理”。我们的具体目的是确定：（1）4种精神障碍的长期风险（主要 PC幸存者中的抑郁，焦虑，酒精和药物使用障碍）和自杀； （2）高风险亚组 干预措施可能会受益最多； （3）精神障碍是否与较高的PC特异性有关 死亡; （4）PC幸存者合作伙伴的精神障碍和自杀的长期风险。提议 研究很重要，因为数以百万计的男性正在使用PC，他们的心理健康后遗症可能 具有被研究和预防的实质性影响。它具有创新性，因为它将提供第一个 通过整合无与伦比的个人 - > 4 m人的水平数据。结果将确定PC幸存者的长期心理健康成果， 合作伙伴和高风险亚组，并指导早期干预措施以改善其长期健康状况。