Abstract

Background

Late physical and psychological effects of prostate cancer (PCa) are well documented. Less is known about social outcomes and risk factors for poorer social outcomes. The Life After Prostate Cancer Diagnosis (LAPCD) study is a United Kingdom whole population evaluation of outcomes following PCa diagnosis. Study Aims: 1) To investigate predictors of social distress following PCa diagnosis; 2) To compare outcomes with a general population (GenPop) sample.

Method

Cross-sectional postal survey of all men diagnosed with PCa in the UK 18-42 months previously. Measures included clinical and sociodemographic items and the validated Social Difficulties Inventory (SDI), from which respondents can be grouped as ‘socially distressed’/‘not socially distressed’. Men from the Northern Ireland (NI) General Population (GenPop) were also surveyed. Descriptive, univariable and multivariable logistic regression analyses were undertaken on overall LAPCD and separately on the combined NI cohorts.

Results

35,823 (60.8%) men with PCa responded and 29.5% (n=2,955) GenPop. The proportion of ‘socially distressed’ men was 9.4% overall LAPCD, 12.4% NI-only LAPCD, and 12.9% GenPop.  Key predictors of social distress in the overall LAPCD group were: unemployment (Odds Ratio (OR): 11.58; 95% CI 9.16-14.63) and having ≥3 co-morbidities (OR: 5.37; 95% CI 4.61-6.27). Other significant predictors included combination treatments or Androgen Deprivation Therapy, prior support for mental health/drug or alcohol related problems, and living in an area of greater deprivation.

Similar sociodemographic predictors were observed in the regression analysis of the combined NI cohorts (LAPCD and GenPop). A diagnosis of PCa added only slightly to the model (OR: 1.54; 95% CI 1.06-2.12).

Conclusion

These findings could be used to develop a simple checklist which may help clinicians identify men at high risk of social distress who may benefit from additional information, support or referral for specialist help.