Andrea Piccolini, Zhiyu Qian, Stephan M Korn, Filippo Dagnino, Klara Pohl, Hanna Zurl, Yvonne Lei, Nora Y Osman, Giovanni Lughezzani, Nicolò M Buffi, Quoc-Dien Trinh, Alexander P Cole
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引用次数: 0
Abstract
Objective: To explore the relationship between mental health status and prostate-specific antigen (PSA) screening, given that poor mental health may reduce engagement in preventive health behaviors.
Methods: We analyzed data from the 2018 and 2020 Behavioral Risk Factor Surveillance System (BRFSS) surveys, including men aged 50-69 years without history of prostate cancer. The primary outcome was self-reported PSA screening in the past two years. Poor mental health was defined as at least 14 days of self-reported poor mental health or a depressive disorder diagnosis. Covariates included socio-demographic variables, chronic comorbidities, and healthcare access. Logistic regression assessed associations between mental health, PSA screening, and covariates.
Results: A total of 114,972 men were included, representing a weighted population of 30.5 million. Of them, 81.9% and 18.1% had good and poor mental health, respectively. The overall PSA screening rate was 28.2%. Men with good mental health were more likely to undergo PSA screening (29.3% vs 23.2%; p<0.001). Poor mental health was associated with 10% lower odds of PSA screening (aOR: 0.90 [0.83-0.98]). Higher adherence was observed among older participants (aOR: 2.54), with higher education levels (aOR: 1.95), or married (aOR: 1.21). Having at least one personal doctor (aOR: 2.86) was a strong predictor of PSA screening.
Conclusions: Men with poor mental health are less likely to undergo PSA screening. Addressing mental health barriers is essential to improve preventive care. Integrated care models with mental health support may reduce disparities and enhance prostate cancer outcomes in this population.
目的：探讨心理健康状况与前列腺特异性抗原（PSA）筛查之间的关系，因为心理健康状况不佳可能会减少预防性健康行为的参与。方法：我们分析了2018年和2020年行为风险因素监测系统（BRFSS）调查的数据，包括50-69岁无前列腺癌病史的男性。主要结果是自我报告的过去两年的PSA筛查。精神健康状况不佳的定义是自我报告的精神健康状况不佳或被诊断为抑郁症至少14天。协变量包括社会人口统计学变量、慢性合并症和医疗保健可及性。逻辑回归评估了心理健康、PSA筛查和协变量之间的关联。结果：共纳入114,972名男性，加权人口为3050万。其中心理健康状况良好的占81.9%，心理健康状况不佳的占18.1%。总体PSA筛查率为28.2%。心理健康状况良好的男性更有可能接受PSA筛查(29.3% vs 23.2%；结论：心理健康状况较差的男性不太可能接受PSA筛查。解决心理健康障碍对于改善预防保健至关重要。结合心理健康支持的综合护理模式可以减少差异，提高这一人群的前列腺癌预后。
期刊介绍：
Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology
The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.
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