To evaluate the mental health outcomes of patients with testicular cancer (TC) and identify the relative risk of mental health diagnoses following TC diagnosis compared to a control population without TC.
The TriNetX Diamond network database was queried for men between 15-45 years undergoing radical orchiectomy for TC and compared to an age-matched control group of men who underwent an orchiectomy for testicular torsion. Patients with history of mental health disorders, with nodal/metastatic disease, and patients who underwent chemotherapy, radiotherapy, or RPLND were excluded. A 1:1 propensity score matching was performed to compare the prevalence of newly diagnosed anxiety disorders, sleep disorders, and depressive episodes anytime following orchiectomy.
A total of 9,264 males underwent an orchiectomy. After matching for age, race, and use of antidepressants/antipsychotics, 2,178 men were included (1,089 radical and 1,089 simple orchiectomies). After propensity score matching, patients with TC had significantly higher rates of newly diagnosed depression (8.4% vs 3.1%; p<0.01), anxiety (17.6% vs 7.1%; p<0.01), and sleep disorders (9.0% vs 3.6%; p<0.01) compared to patients undergoing simple orchiectomy. Patients diagnosed with TC had a 2.7-fold higher relative risk of developing depression, 2.5-fold higher risk of anxiety, and 2.5-fold higher risk of sleep disorders compared to the control population.
Receiving a TC diagnosis was associated with greater prevalence of newly diagnosed anxiety, sleep disorders, and depression. These findings indicate that the cancer diagnosis itself, rather than the orchiectomy, is likely a driver of mental health disorders in this young patient group.
Urology. 2026 Feb 20 [Epub ahead of print]
Joshua Wang, Jersey-Kate Castillo, Matthew Buell, John Shin, Antoin Douglawi, Martin Hofmann, Brian Hu, Herbert Ruckle, Muhannad Alsyouf
University of California, Riverside School of Medicine, 900 University Ave, Riverside, CA 92521, USA., Department of Urology, Loma Linda University Health, 11234 Anderson St, Room A560, Loma Linda, CA 92354, USA., Department of Hematology-Oncology, Loma Linda University Health, 11175 Campus St, CSP 11015, Loma Linda, CA 92354, USA., Department of Urology, Loma Linda University Health, 11234 Anderson St, Room A560, Loma Linda, CA 92354, USA; Division of Urology, Riverside University Health System, 26520 Cactus Ave, Moreno Valley, CA 92555, USA., Department of Urology, Loma Linda University Health, 11234 Anderson St, Room A560, Loma Linda, CA 92354, USA; Division of Urology, Riverside University Health System, 26520 Cactus Ave, Moreno Valley, CA 92555, USA. Electronic address: .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/41724395