C139
Psychological distress and prostate specific antigen levels in men with and without prostate cancer
Emma Turner1, Athene Lane1, Chris Metcalfe1, Liz Down1, Freddie Hamdy3, David Neal2, Jenny Donovan1, Kavita Vedhara1
1University of Bristol, Bristol, UK, 2University of Cambridge, Cambridge, UK, 3University of Sheffield, Sheffield, UK
Background
The role of psychological distress in the onset and progression of prostate cancer is an under-researched area. We report results from a large study in which we have examined the relationship between indices of psychological distress and prostate specific antigen (PSA) levels in men with and without prostate cancer, including the relationship between distress and cancer diagnosis.
Method
Data were obtained from 4,886 men who attended PSA testing and biopsy as part of the ProtecT (Prostate testing for cancer and treatment) study (mean age 62 years; 98.9% White). Men completed questionnaires measuring anxiety, depression and urinary symptoms at PSA testing and again at biopsy.
Results
There was no evidence of associations between mean anxiety or depression and PSA level at biopsy. When data from men with and without prostate cancer were examined separately, no associations were found in men without prostate cancer. However depression was positively associated with PSA levels in men with prostate cancer, reflecting an 8.6% increase in PSA for every five-unit increase in depression. Logistic regressions suggested men with ‘possible’ clinical depression at PSA testing (519/4886) were 23% more likely to have a diagnosis of prostate cancer.
Conclusion
This highlights the need for further investigations into the possible role of depressed mood in the onset of prostate cancer. Although these data were essentially correlational in nature and thus, it is difficult to disentangle cause from effect. Indeed, it remains possible that that the presence of, as yet undiagnosed, neoplastic disease, results in greater depressed mood.
