Key result
Major depressive symptoms linked to ~156% higher mortality in White prostate cancer patients.
Why the study?
Psychosocial factors may influence prostate cancer survival, but evidence is limited for low-income populations.
Do psychosocial factors like depressive symptoms and perceived lack of control affect overall mortality in low-income Black and White men with prostate cancer?
Cohort (n=1,367)
Yes
Do psychosocial factors like depressive symptoms and perceived lack of control affect overall mortality in low-income Black and White men with prostate cancer?
Effect estimate: aHR 2.56 (95% CI 1.13-5.77)
p-value: p=0.01
Psychosocial factors such as depressive symptoms and perceived lack of control are associated with increased mortality in White men with prostate cancer, but associations differ significantly by race.
May identify white men at higher mortality risk from depressive symptoms; leaves open causality and intervention benefit.
INTRODUCTION: Psychosocial factors may influence PCa survival, but evidence is limited for low-income populations. METHODS: This study utilized data from the Southern Community Cohort Study (SCCS), a prospective cohort of ∼85,000 individuals aged 40 to 79, from predominantly low-income backgrounds, enrolled between 2002 to 2009 across 12 southeastern states. A total of 1,367 men (1,058 Black and 309 White) found with PCa during the follow-up of 34,313 men were included. The Kaplan-Meier method was used to generate 5-year survival rates with log-rank tests for statistical significance. Multivariable Cox models were used to estimate adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for psychosocial-mortality associations. RESULTS: Over 18-years of follow-up, 291 Black (27.5%) and 59 White (19.1%) PCa patients died (P=0.03). White men self-reporting major depressive symptoms and their inability to control important things in life (ITC) had an 11% (Psurvival = 0.01) and 12% (Psurvival = 0.01) lower 5-year survival compared to those that didn't, with aHR of 2.56, (95% CI = 1.13-5.77) and 2.30 (95% CI = 1.07-4.95), respectively. Inverse associations were found for per SD increase in depression score (aHR = 0.84, 95%CI = 0.74-0.96.) among black patients. Testing for multiplicative interaction was significant for race-depression (Pinteraction = 0.02) and race-ITC (Pinteraction 0.04). The associations were mainly seen among PCa cases diagnosed within 5 years after baseline survey. CONCLUSION: Psychosocial-mortality associations among PCa patients are complex and may not affect individuals equally. Programs aiming to reduce mortality for individuals with PCa should consider their psychosocial needs and demographic background.
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DeMoulin et al. (2026) conducted a cohort in Prostate cancer (n=1,367). Major depressive symptoms and inability to control important things vs. Absence of these symptoms was evaluated on Overall mortality (aHR 2.56, 95% CI 1.13-5.77, p=0.01). Major depressive symptoms were associated with increased mortality in White prostate cancer patients (aHR 2.56; 95% CI 1.13-5.77), with a significant race-depression interaction (P=0.02).
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