Predictors of psychological well-being among prostate cancer survivors (pp. 3-99)

Publication date: 
November, 2013
Presentation type: 
Poster presentation
Related staff: 
Dr Frances Drummond (former staff)


Rising incidence and survival means prostate cancer (PCa) is the most prevalent cancer in men in developed countries.  In contrast to 20 years ago, many men with PCa are asymptomatic, diagnosed in primary care through ‘screening' prostate specific antigen tests.   The growing burden and changing routes to diagnosis makes it important to understand how PCa impacts on survivors' wellbeing.  However, information on long-term psychological wellbeing is lacking.  We investigated predictors of psychological well-being among PCa survivors.


A postal questionnaire was developed and administered in 2012 to 6,937 PCa (ICD10 C61) survivors 1.5-15 years post-diagnosis, identified through population-based cancer registries in the Republic of Ireland (RoI) and Northern Ireland (NI). Based on self-reported data, "screen-detected" men were defined as those who were asymptomatic and diagnosed via PSA testing, "symptomatic" men had urinary symptoms at diagnosis.  Psychological well-being was assessed using the Depression Anxiety Stress Scales-21.  Logistic regression was used to identify associations between method of diagnosis, clinical and socio-demographic factors and depression, anxiety and stress of any severity.  This preliminary analysis includes the first 1,402 respondents.


Response was 58%.  Depression, anxiety and stress (any severity) were present in 19%, 14%, 25% of survivors, respectively. 56% were screen-detected.  Method of detection was associated with increased risk of negative emotional states in univariate analyses.  In adjusted analysis, depression risk was increased in unmarried men (OR=1.85,95%CI 1.16-2.96) and those with co-morbidities (OR=1.57,95%CI 1.07-2.29); and reduced in survivors without current incontinence (OR=0.56,95%CI 0.33-0.97) or fatigue (OR=0.58,95%CI 0.36-0.91).  Men undergoing watchful waiting/active surveillance had 5-times higher risk of depression than men treated in other ways (OR=5.01,95%CI 2.32-11.21). Risk did not vary by time-since-diagnosis.  Similar associations were found for anxiety and stress. 


Prevalence of anxiety and depression was high among PCa survivors.  Although method of detection was not associated with psychological wellbeing, risks of depression, anxiety and stress were increased in men with particular persistent treatment after-effects i.e. incontinence and fatigue, and in men who were being managed by watchful waiting/active surveillance.

Research Implications

This study shows evidence of poor psychological health in groups of PCa survivors.  Given that men are living longer with PCa, further research into factors affecting the psychological well-being of long-term PCa survivors is warranted, and development of interventions to support survivors' psychological wellbeing should be developed and rigorously evaluated before implementation.

Clinical Implications

Healthcare professionals need to be aware of the prevalence of negative emotional states in PSA survivors.  These findings suggest that screening for depression, anxiety and stress should form part of routine follow-up of PCa survivors.

Acknowledgement of Funding

This work was funded by the Health Research Board Ireland and the Prostate Cancer Charity UK.

Published abstract: 
Drummond FJ, Kinnear K, O'Leary E, Gavin A, Sharp L
Drummond FJ
Conference/meeting title: 
IPOS (International Psycho-oncology Society)
Event date: 
8 Nov 2013
Rotterdam, Netherlands

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