A Systematic Review on the Impact of Stigma, Anxiety, Depression on Quality of Life Among Prostate Cancer Patients

BACKGROUND: Prostate cancer (PCa) is associated with a high burden of psychological distress, including stigma, anxiety, and depression. This systematic review assessed the impacts of anxiety, depression, and psychological stress on the quality of life (QoL) among prostate cancer patients. METHODS: A robust literature search was conducted in Scopus, PubMed and Google Scholar according to the PRISMA Checklist 2020 in synthesising results from relevant studies. Observational studies written in English and published from 2010 to 2025 were analysed. Quality assessment was performed using the Newcastle-Ottawa Scale. Nineteen studies met the inclusion criteria. RESULTS: The pooled prevalence of anxiety and depression among prostate cancer patients was 24% and 32%, respectively. Anxiety was significantly associated with reduced QoL, showing moderate to strong effect sizes. Depression and perceived stigma were also linked to poorer QoL, though with weaker to moderate effects, suggesting that anxiety may have a greater impact on QoL than the other factors. Psychological stress was associated with lower QoL. The most affected QoL domains were mental health, emotional functioning, social well-being, and physical health. Most studies (n = 18) had a low to moderate risk of bias. CONCLUSION: Anxiety, depression, and perceived stigma were found to negatively impact multiple QoL domains among prostate cancer patients. These findings highlight the importance of incorporating routine psychosocial screening and targeted interventions into prostate cancer care to help mitigate QoL impairments.