Mental Health Burden of a Testicular Cancer Diagnosis: Insights from a Large Claims Database

To evaluate the mental health outcomes of patients with testicular cancer (TC) and identify the relative risk of mental health diagnoses following TC diagnosis compared to a control population without TC. The TriNetX Diamond network database was queried for men between 15-45 years undergoing radical orchiectomy for TC and compared to an age-matched control group of men who underwent an orchiectomy for testicular torsion. Patients with history of mental health disorders, with nodal/metastatic disease, and patients who underwent chemotherapy, radiotherapy, or RPLND were excluded. A 1:1 propensity score matching was performed to compare the prevalence of newly diagnosed anxiety disorders, sleep disorders, and depressive episodes anytime following orchiectomy. A total of 9,264 males underwent an orchiectomy. After matching for age, race, and use of antidepressants/antipsychotics, 2,178 men were included (1,089 radical and 1,089 simple orchiectomies). After propensity score matching, patients with TC had significantly higher rates of newly diagnosed depression (8.4% vs 3.1%; p<0.01), anxiety (17.6% vs 7.1%; p<0.01), and sleep disorders (9.0% vs 3.6%; p<0.01) compared to patients undergoing simple orchiectomy. Patients diagnosed with TC had a 2.7-fold higher relative risk of developing depression, 2.5-fold higher risk of anxiety, and 2.5-fold higher risk of sleep disorders compared to the control population. Receiving a TC diagnosis was associated with greater prevalence of newly diagnosed anxiety, sleep disorders, and depression. These findings indicate that the cancer diagnosis itself, rather than the orchiectomy, is likely a driver of mental health disorders in this young patient group.