Impact of Psychological Distress on Prostate Cancer Screening in U.S. Military Veterans

Abstract

The benefit of routine prostate cancer screening is currently under debate; however, many experts recommend that men with elevated risk for the disease discuss the potential risks and benefits of screening with their health care team. Psychological factors have been negatively associated with preventive health behaviors such as cancer screenings. The purpose of this study was to investigate the impact of depressive and trauma-related symptoms on prostate cancer screening behaviors and relevant health care perceptions among a sample of U.S. military veterans, as veterans are at higher risk for prostate cancer, depression, and posttraumatic stress disorder than the general population. Participants ( n = 350) were a national sample of predominantly Caucasian (84.6%) male U.S. military veterans (60.5 years ± 8.9) who completed an online questionnaire regarding past prostate cancer screening engagement, as well as validated measures of depression, posttraumatic stress disorder, and perceived barriers and benefits to prostate cancer screening. Results indicate that greater depressive symptoms, trauma-related symptoms, and perceived barriers were associated with lower rates of past prostate cancer screening among this veteran sample and that greater depressive and trauma-related symptoms were associated with greater perceived barriers to prostate cancer screening. As prostate cancer screening recommendations continue to evolve, it is important for health care providers not only to discuss pros and cons of screening with high risk men but also to consider the impact of psychological distress on the decision-making process.

Meeting the guidelines: Implementing a distress screening intervention for veterans with cancer

“…These findings are particularly important given the unique sample characteristics of a largely underrepresented group in psycho‐oncology distress screening evaluations—AA males of lower SES. Previous studies have predominately evaluated large community/academic hospitals that include primarily Whites with high proportions of females, and markedly low rates of AAs 21–23 . Understanding the specific needs of AA males with cancer is critical in reducing disparities, as they experience 14% higher incidence rates of all cancers and 33% higher death rates compared to their White male counterparts 24 .…”

“…We Previous studies have predominately evaluated large community/ academic hospitals that include primarily Whites with high proportions of females, and markedly low rates of AAs. [21][22][23] Understanding the specific needs of AA males with cancer is critical in reducing disparities, as they experience 14% higher incidence rates of all cancers and 33% higher death rates compared to their White male counterparts. 24 Almost 70% of males in this cohort had advanced disease (stages III andIV) with 86% reporting elevated physical concerns.…”

Pharmacological and non-pharmacological treatments for major depressive disorder: review of systematic reviews

“…2 In the USA, the estimated lifetime prevalence of MDD is 16%. 3 In addition to its burden of disease, MDD exerts a negative impact on physical health [4][5][6][7] and adherence to medical treatment. 8 9 Second-generation antidepressants (eg, selective serotonin reuptake inhibitors or selective serotonin norepinephrine reuptake inhibitors) are the most commonly used treatments for acute MDD.…”

Baseline Attitudes About Prostate Cancer Screening Moderate the Impact of Decision Aids on Screening Rates

“…A growing body of literature suggests that there are a variety of factors that influence participation in cancer control behaviors, including demographic, situational, and psychosocial factors [14–17]. Specifically, research has found that attitudes may reduce patients’ intentions to engage in cancer-related behaviors, such as information seeking [18] and treatment decision making [19].…”