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

基本信息

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
项目类别：
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

项目摘要

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男性中最常诊断出的癌症全世界。目前有超过 360 万美国男性使用 PC，这一数字预计将增加到超过 5 到 2030 年，大约 90% 的 PC 病例是在地方或区域阶段诊断的，当 5 年存活率>99%。因此，大多数患有 PC 的男性在诊断后存活超过 15-20 年。然而，个人电脑诊断和治疗对男性及其伴侣来说可能是毁灭性的，并可能增加精神疾病的风险疾病。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。尽管精神障碍给公共卫生带来沉重负担，但与 PC 的躯体结果相比，这些结果的研究严重不足。对长期的全面了解迫切需要短期心理健康后遗症来改善 PC 幸存者及其患者的护理和结果合作伙伴。先前的少数研究有重要的局限性，包括有限的随访时间和样本仅使用医院数据来确定精神障碍，仅捕获最严重的情况案例。没有大规模研究纳入合作伙伴。我们将通过进行第一个对全国队列中 PC 幸存者及其伴侣的心理健康结果进行全面的长期研究（N >4 M）使用来自初级保健、专科门诊和住院环境的高度完整的数据。我们假设 PC 幸存者及其伴侣患严重精神障碍和自杀的风险增加。为了检验这一假设，我们将检查瑞典 210,432 名诊断患有 PC 的男性的结果 1987-2018 年期间，他们的伴侣数量为 163,085 名，而没有 PC 的男性人数为 210 万，伴侣数量为 160 万。到 2020 年长达 34 年。瑞典是一个理想的环境，因为 PC 可以诊断个人级别的数据，经过 3 多年的跟踪，整个人群可以获得治疗和心理健康结果， PC和常见精神障碍的发病率和治疗情况与美国相当。这该提案涉及 2019 年 NCI 研讨会“癌症证据差距”确定的关键优先事项我们的具体目标是确定：(1) 4 种精神障碍（主要是 PC 幸存者的抑郁、焦虑、酒精和吸毒障碍）和自杀； (2)高危人群可能从干预措施中获益最多； (3)精神障碍是否与较高的PC特异性相关死亡; (4) PC 幸存者的伴侣出现精神障碍和自杀的长期风险。拟议的这项研究意义重大，因为数以百万计的男性患有 PC，他们的心理健康后遗症可能具有尚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通过整合无与伦比的个人数据，对全国 PC 幸存者和伴侣群体进行长期评估 >400 万人的水平数据。结果将确定 PC 幸存者的长期心理健康结果、他们的合作伙伴和高风险亚群体，并指导早期干预措施以改善他们的长期健康。