TY - JOUR
AU - A. Piccolini
AU - Z. Qian
AU - S. M. Korn
AU - F. Dagnino
AU - K. Pohl
AU - H. Zurl
AU - Y. Lei
AU - N . Y. Osman
AU - G. Lughezzani
AU - N. M. Buffi
AU - Q. D. Trinh
AU - A. P. Cole
A1 - 
AB - OBJECTIVE: To explore the relationship between mental health status and prostate-specific antigen (PSA) screening, given that poor mental health may reduce engagement in preventive health behaviors. METHODS: We analyzed data from the 2018 and 2020 Behavioral Risk Factor Surveillance System surveys, including men aged 50-69 years without history of prostate cancer. The primary outcome was self-reported PSA screening in the past two years. Poor mental health was defined as at least 14 days of self-reported poor mental health or a depressive disorder diagnosis. Covariates included socio-demographic variables, chronic comorbidities, and healthcare access. Logistic regression assessed associations between mental health, PSA screening, and covariates. RESULTS: A total of 114,972 men were included, representing a weighted population of 30.5 million. Of them, 81.9% and 18.1% had good and poor mental health, respectively. The overall PSA screening rate was 28.2%. Men with good mental health were more likely to undergo PSA screening (29.3% vs 23.2%; P <.001). Poor mental health was associated with 10% lower odds of PSA screening (aOR: 0.90 [0.83-0.98]). Higher adherence was observed among older participants (aOR: 2.54), with higher education levels (aOR: 1.95), or married (aOR: 1.21). Having at least one personal doctor (aOR: 2.86) was a strong predictor of PSA screening. CONCLUSION: Men with poor mental health are less likely to undergo PSA screening. Addressing mental health barriers is essential to improve preventive care. Integrated care models with mental health support may reduce disparities and enhance prostate cancer outcomes in this population.
AD - Department of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Urology, IRCCS Humanitas Research Hospital, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy. Electronic address: andrea.piccolini01@gmail.com.; Department of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. Electronic address: zhiyu.qian.jason@gmail.com.; Department of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Urology, Medical University of Vienna, Vienna, Austria. Electronic address: stephan.korn@meduniwien.ac.at.; Department of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Urology, IRCCS Humanitas Research Hospital, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy. Electronic address: f.dagnino97@gmail.com.; Department of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Urology, Medical University of Graz, Graz, Austria. Electronic address: klarapohl@posteo.net.; Department of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Urology, Medical University of Graz, Graz, Austria. Electronic address: hanna.zurl@medunigraz.at.; Department of Medicine, Brigham and Women's Hospital, Boston, MA. Electronic address: yylei@mgb.org.; Department of Medicine, Brigham and Women's Hospital, Boston, MA. Electronic address: nosman@bwh.harvard.edu.; Department of Urology, IRCCS Humanitas Research Hospital, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy. Electronic address: giovanni.lughezzani@hunimed.eu.; Department of Urology, IRCCS Humanitas Research Hospital, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy. Electronic address: nicolo.buffi@hunimed.eu.; Department of Urology, University of Pittsburgh, Pittsburgh, PA. Electronic address: trinh.qd@gmail.com.; Department of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. Electronic address: alexander.p.cole@gmail.com.
AN - 40517823
BT - Urology
C5 - Healthcare Disparities
DA - Oct
DO - 10.1016/j.urology.2025.06.016
DP - NLM
ET - 20250613
JF - Urology
LA - eng
N2 - OBJECTIVE: To explore the relationship between mental health status and prostate-specific antigen (PSA) screening, given that poor mental health may reduce engagement in preventive health behaviors. METHODS: We analyzed data from the 2018 and 2020 Behavioral Risk Factor Surveillance System surveys, including men aged 50-69 years without history of prostate cancer. The primary outcome was self-reported PSA screening in the past two years. Poor mental health was defined as at least 14 days of self-reported poor mental health or a depressive disorder diagnosis. Covariates included socio-demographic variables, chronic comorbidities, and healthcare access. Logistic regression assessed associations between mental health, PSA screening, and covariates. RESULTS: A total of 114,972 men were included, representing a weighted population of 30.5 million. Of them, 81.9% and 18.1% had good and poor mental health, respectively. The overall PSA screening rate was 28.2%. Men with good mental health were more likely to undergo PSA screening (29.3% vs 23.2%; P <.001). Poor mental health was associated with 10% lower odds of PSA screening (aOR: 0.90 [0.83-0.98]). Higher adherence was observed among older participants (aOR: 2.54), with higher education levels (aOR: 1.95), or married (aOR: 1.21). Having at least one personal doctor (aOR: 2.86) was a strong predictor of PSA screening. CONCLUSION: Men with poor mental health are less likely to undergo PSA screening. Addressing mental health barriers is essential to improve preventive care. Integrated care models with mental health support may reduce disparities and enhance prostate cancer outcomes in this population.
PY - 2025
SN - 0090-4295
SP - 112
EP - 120+
ST - Exploring the Impact of Mental Health on PSA Screening: Insights From a Population-Based Survey
T1 - Exploring the Impact of Mental Health on PSA Screening: Insights From a Population-Based Survey
T2 - Urology
TI - Exploring the Impact of Mental Health on PSA Screening: Insights From a Population-Based Survey
U1 - Healthcare Disparities
U3 - 10.1016/j.urology.2025.06.016
VL - 204
VO - 0090-4295
Y1 - 2025
ER -