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Association between androgen deprivation therapy and anxiety among 78 000 patients with localized prostate cancer
Author(s) -
Dinh Kathryn T,
Yang David D,
Nead Kevin T,
Reznor Gally,
Trinh QuocDien,
Nguyen Paul L
Publication year - 2017
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.13409
Subject(s) - medicine , androgen deprivation therapy , anxiety , prostate cancer , hazard ratio , confidence interval , cohort , proportional hazards model , relative risk , oncology , cohort study , cancer , psychiatry
Objectives To examine whether any androgen deprivation therapy use or longer duration is associated with an increased risk of anxiety in patients with prostate cancer. Methods We identified 78 552 men aged ≥66 years with stage I–III prostate cancer using the Surveillance, Epidemiology, and End Results‐Medicare linked database from 1992 to 2006, excluding patients with psychiatric diagnoses within the year prior or 6 months after prostate cancer diagnosis. Multivariable Cox regression was used to examine the association between pharmacological androgen deprivation therapy and diagnosis of anxiety. Results The 43.1% (33 882) of patients who received androgen deprivation therapy experienced a higher 3‐year cumulative incidence of anxiety compared with men who did not (4.1% vs 3.5%, P < 0.001). Any androgen deprivation therapy use was associated with a nearly significant increased risk of anxiety (adjusted hazard ratio 1.08, 95% confidence interval 1.00–1.17, P = 0.054). There was a significant trend between a longer duration of therapy and increased risk of anxiety ( P ‐trend = 0.012), with a 16% higher risk for ≥12 months (adjusted hazard ratio 1.16, 95% confidence interval 1.04–1.29, P = 0.010). Conclusions Androgen deprivation therapy was associated with an elevated risk of anxiety in this cohort of elderly men with localized prostate cancer, with the risk higher with a longer duration of treatment. Anxiety should be considered among the possible psychiatric effects of androgen deprivation therapy and discussed before initiating treatment, particularly if a long course is anticipated.