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Greetings! I hope you are well.

I am writing on behalf of an international publishing house, Science and Education Publishing, USA (http://www.sciepub.com).

Science and Education Publishing (SciEP) is a multidisciplinary open access publisher of Journals covering the fields of Science, Technology and Medicine. All SciEP publications are subject to high-quality peer review, editorial and production processes and are freely available online.

Welcome to the April, 2013 edition of SciEP newsletter, providing monthly summaries of articles on science & education related topics of interest to scientist and professionals. The mission of our journals is to provide an open access forum for publishing new findings on issues pertinent to scientific and academic field. We also invite you to submit original research papers, review articles, short reports, or case studies are considered for publication in our Multidisciplinary Journals.

American Journal of Public Health Research
DOI: 10.12691/ajphr-1-1-3

The Implementation of a Tele-Homecare System with Service Oriented Architecture and HL7 Message Transmission Standard
Ching-Sung Wang

American Journal of Medical and Biological Research
DOI: 10.12691/ajmbr-1-1-2

The Influence of Ethanol on Pyruvate Kinases Activity in Vivo, in Vitro, in Silico
Lelevich Sergey Vladimirovich, Khrustalev Vladislav Victorovich, Barkovsky Eugene Victorovich, Shedogubova Tatyana Aleksandrovna

American Journal of Medical Sciences and Medicine
DOI: 10.12691/ajmsm-1-1-1

Clinical and Histological Features in Wegener Granulomatosis
Li Cavoli Gioacchino, Passantino Rita, Bono Luisa, Tortorici Calogera, Ferrantelli Angelo, Giammarresi Carlo, Rotolo Ugo

American Journal of Infectious Diseases and Microbiology
DOI: 10.12691/ajidm-1-1-2

The Curse of Lymphatic Filariasis: Would the Continual Use of Diethylcarbamazine Eliminate this Scourge in Papua New Guinea?
Anne Lanham, Lillian Mwanri

We have released issues of some journals on February 2013.
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American Journal of Cancer Prevention
American Journal of Medicine Studies
American Journal of Infectious Diseases and Microbiology
American Journal of Cardiovascular Disease Research
American Journal of Biomedical Research
American Journal of Mechanical Engineering
American Journal of Microbiological Research
Journal of Preventive Medicine
American Journal of Food and Nutrition
American Journal of Hypertension Research
American Journal of Sports Science and Medicine
Journal of Cancer Research and Treatment
American Journal of Zoological Research
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Label_Title

Dear Label_Name,

Greetings! I hope you are well.

I am writing on behalf of an international publishing house, Science and Education Publishing, USA (http://www.sciepub.com).

Science and Education Publishing (SciEP) is a multidisciplinary open access publisher of Journals covering the fields of Science, Technology and Medicine. All SciEP publications are subject to high-quality peer review, editorial and production processes and are freely available online.

Welcome to the April, 2013 edition of SciEP newsletter, providing monthly summaries of articles on science & education related topics of interest to scientist and professionals. The mission of our journals is to provide an open access forum for publishing new findings on issues pertinent to scientific and academic field. We also invite you to submit original research papers, review articles, short reports, or case studies are considered for publication in our Multidisciplinary Journals.

American Journal of Public Health Research
DOI: 10.12691/ajphr-1-1-3

The Implementation of a Tele-Homecare System with Service Oriented Architecture and HL7 Message Transmission Standard
Ching-Sung Wang

American Journal of Medical and Biological Research
DOI: 10.12691/ajmbr-1-1-2

The Influence of Ethanol on Pyruvate Kinases Activity in Vivo, in Vitro, in Silico
Lelevich Sergey Vladimirovich, Khrustalev Vladislav Victorovich, Barkovsky Eugene Victorovich, Shedogubova Tatyana Aleksandrovna

American Journal of Medical Sciences and Medicine
DOI: 10.12691/ajmsm-1-1-1

Clinical and Histological Features in Wegener Granulomatosis
Li Cavoli Gioacchino, Passantino Rita, Bono Luisa, Tortorici Calogera, Ferrantelli Angelo, Giammarresi Carlo, Rotolo Ugo

American Journal of Infectious Diseases and Microbiology
DOI: 10.12691/ajidm-1-1-2

The Curse of Lymphatic Filariasis: Would the Continual Use of Diethylcarbamazine Eliminate this Scourge in Papua New Guinea?
Anne Lanham, Lillian Mwanri

We have released issues of some journals on February 2013.
American Journal of Public Health Research
American Journal of Medical Sciences and Medicine
American Journal of Medical and Biological Research
American Journal of Pharmacological Sciences
American Journal of Clinical Medicine Research
American Journal of Nursing Research
American Journal of Cancer Prevention
American Journal of Medicine Studies
American Journal of Infectious Diseases and Microbiology
American Journal of Cardiovascular Disease Research
American Journal of Biomedical Research
American Journal of Mechanical Engineering
American Journal of Microbiological Research
Journal of Preventive Medicine
American Journal of Food and Nutrition
American Journal of Hypertension Research
American Journal of Sports Science and Medicine
Journal of Cancer Research and Treatment
American Journal of Zoological Research
Journal of Biomedical Engineering and Technology
American Journal of Microbiological Research
Biomedical Science and Engineering

We are pleased to announce that submissions are now being accepted for peer review for all the journals across all our subject areas in SciEP.

Please submit your manuscript via our online submission system:
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Label_Title

Dear Label_Name,

Greetings! I hope you are well.

I am writing on behalf of an international publishing house, Science and Education Publishing, USA (http://www.sciepub.com).

Science and Education Publishing (SciEP) is a multidisciplinary open access publisher of Journals covering the fields of Science, Technology and Medicine. All SciEP publications are subject to high-quality peer review, editorial and production processes and are freely available online.

Welcome to the April, 2013 edition of SciEP newsletter, providing monthly summaries of articles on science & education related topics of interest to scientist and professionals. The mission of our journals is to provide an open access forum for publishing new findings on issues pertinent to scientific and academic field. We also invite you to submit original research papers, review articles, short reports, or case studies are considered for publication in our Multidisciplinary Journals.

American Journal of Public Health Research
DOI: 10.12691/ajphr-1-1-3

The Implementation of a Tele-Homecare System with Service Oriented Architecture and HL7 Message Transmission Standard
Ching-Sung Wang

American Journal of Medical and Biological Research
DOI: 10.12691/ajmbr-1-1-2

The Influence of Ethanol on Pyruvate Kinases Activity in Vivo, in Vitro, in Silico
Lelevich Sergey Vladimirovich, Khrustalev Vladislav Victorovich, Barkovsky Eugene Victorovich, Shedogubova Tatyana Aleksandrovna

American Journal of Medical Sciences and Medicine
DOI: 10.12691/ajmsm-1-1-1

Clinical and Histological Features in Wegener Granulomatosis
Li Cavoli Gioacchino, Passantino Rita, Bono Luisa, Tortorici Calogera, Ferrantelli Angelo, Giammarresi Carlo, Rotolo Ugo

American Journal of Infectious Diseases and Microbiology
DOI: 10.12691/ajidm-1-1-2

The Curse of Lymphatic Filariasis: Would the Continual Use of Diethylcarbamazine Eliminate this Scourge in Papua New Guinea?
Anne Lanham, Lillian Mwanri

We have released issues of some journals on February 2013.
American Journal of Public Health Research
American Journal of Medical Sciences and Medicine
American Journal of Medical and Biological Research
American Journal of Pharmacological Sciences
American Journal of Clinical Medicine Research
American Journal of Nursing Research
American Journal of Cancer Prevention
American Journal of Medicine Studies
American Journal of Infectious Diseases and Microbiology
American Journal of Cardiovascular Disease Research
American Journal of Biomedical Research
American Journal of Mechanical Engineering
American Journal of Microbiological Research
Journal of Preventive Medicine
American Journal of Food and Nutrition
American Journal of Hypertension Research
American Journal of Sports Science and Medicine
Journal of Cancer Research and Treatment
American Journal of Zoological Research
Journal of Biomedical Engineering and Technology
American Journal of Microbiological Research
Biomedical Science and Engineering

We are pleased to announce that submissions are now being accepted for peer review for all the journals across all our subject areas in SciEP.

Please submit your manuscript via our online submission system:
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Food Security, Mental Health Status and Prostate Cancer in US Men: 2023 NHIS Data

Marsha Richards, Yonaleska Russo, Sahary Duarte, Tenzing Jempel, Elgloria A. Harrison, Apeksha Mewani, Sheila Hankin, Alsacia Sepulveda-Pacsi, Collette M. Brown*

School of Health Sciences, Human Services and Nursing, Lehman College, Bronx, NY 10468, USA

Abstract: A diagnosis of prostate cancer can impact men’s mental health status and may decrease their food security status. This study aimed to determine differences in (1) mental health (depression and anxiety) rates, (2) mental health screening, and (3) food security status between men with and without prostate cancer diagnosis. The study utilized secondary data from the 2023 National Health Interview Survey and included 13,457 adult male participants, 483 with prostate cancer. Participants self-reported their physician-diagnosed prostate cancer and mental health status. Mental health status was assessed using the Patient Health Questionnaire-4, a validated screening tool for depression and anxiety. Food security was measured using four items from the United States Department of Agriculture’s household food security survey. Chi-squared test of independence was used to assess the association with each variable. Results indicated that prostate cancer increased with age (p < 0.001) and was more prevalent in non-Hispanic/African American (p < 0.001), overweight (p = 0.017), and married (p < 0.001) men. Mental health outcomes (depression and anxiety) did not differ between men with and without prostate cancer. However, patients with prostate cancer were more likely to take medications for depression (p = 0.036). Overall food security was significantly associated with prostate cancer diagnosis (p = 0.037). Individuals with prostate cancer were more likely to receive food stamps (p = 0.021). Food security is important to reduce nutritional challenges that may also exacerbate psychological distress in men with prostate cancer.

Keywords: food security, mental health, anxiety, depression, prostate cancer

Received July 04, 2025; Revised August 06, 2025; Accepted August 13, 2025

Citation: Marsha Richards, Yonaleska Russo, Sahary Duarte, Tenzing Jempel, Elgloria A. Harrison, Apeksha Mewani, Sheila Hankin, Alsacia Sepulveda-Pacsi, Collette M. Brown, Food Security, Mental Health Status and Prostate Cancer in US Men: 2023 NHIS Data. Journal of Food Security, 13 (3). 99-105. January 2025. doi:10.12691/jfs-13-3-3

1. Introduction

Prostate cancer is the second-highest diagnosed cancer amongst men in the United States, following lung cancer [1]. It is estimated that in 2025, approximately 313,780 new cases will be diagnosed, resulting in approximately 35,770 deaths [1]. While “one in eight men will be diagnosed with prostate cancer during their lifetime,” only 1 in 44 will die of the disease [1].

Prostate cancer is more often detected in men over 64 years old; it is very rare in men under 40 [1,2]. The incidence of prostate cancer tends to be higher among Black and Hispanic men compared to white men with a higher prevalence in African American men and men of Caribbean ancestry [1,2,3]. In addition, advanced-stage of prostate cancer is more prevalent in African American/Black men compared to other groups [4,5,6]. For example, [4] reported that African American men had a 12.3% risk of advanced-stage prostate cancer, and Hispanic men had a 10.5% risk nearly twice that observed in non-Hispanic white men (6.3%). This trend continued over the years, with African American/Black and Hispanic men experiencing higher rates of advanced stage of prostate cancer [7].

Significant mental health challenges following diagnosis can trigger profound psychological distress, including fear, uncertainty, and anxiety. Despite a high 5-year relative survival rate of 97% across all stages [1], the prolonged survivorship associated with prostate cancer makes long-term psychological well-being crucial. Multiple studies have documented the widespread mental health effects of prostate cancer [8,9,10]. For example, nearly a quarter of participants in [8] reported worsening anxiety within a year of diagnosis, and similar findings were observed for depressive symptoms. Moreover, [9] reported that 39.3% of men experienced depressive symptoms, and 28% reported anxiety even before beginning treatment. This psychological burden tends to persist with anxiety levels remaining stable from diagnosis through follow-up. Worsening levels of anxiety and depression highlight the necessity of examining the effectiveness of various mental health interventions.

There is also growing evidence suggesting that mental health issues vary across ethnic groups and at various stages of prostate cancer diagnosis [5,11,12]. Black men with prostate cancer experience significantly higher rates of untreated depression [13], often due to cultural stigma and lack of access to mental health services. Additionally, [6] reported that Black men are more likely to be diagnosed with advanced-stage prostate cancer, further exacerbating psychological distress. Since late-stage diagnoses are strongly associated with increased psychological distress, these disparities highlight the urgent need for culturally sensitive mental health support [14].

While understanding the demographic disparities and mental health impacts of prostate cancer is crucial, it is equally important to explore the broader socioeconomic factors that can significantly influence both diagnosis and treatment. One such factor is food insecurity, which poses unique challenges for patients navigating their health journeys. Food insecurity is a lack of economic and social resources to access enough safe and nutritious foods to achieve an active, healthy lifestyle [23]. Research abounds on food insecurity and different types of cancers [24] [25] [26] [27] [28] [29] [30] [31], and on nutrition and prostate cancer [32,33,34,35], but there is limited research on food security status among patients with prostate cancer [36,37].

According to [36], patients with prostate cancer were less likely to report new or persistent food insecurity than those without prostate cancer. However, those who were food insecure were more likely than food secure survivors to forgo, delay, or make changes to all types of medical services. Better diet quality is shown to decrease the incidence of prostate cancer; however, food insecure individuals tend to have poorer diets, therefore increasing their risk of prostate cancer [38,39].

Expanding research efforts in these areas is crucial for shaping improved healthcare policies and creating more patient-centered treatment strategies. Integrating mental health services into oncology care could lead to improved overall patient outcomes by providing comprehensive support throughout the cancer journey [40,41]. Proactively addressing mental health and food insecurity can ensure a more holistic approach to patient care and promote long-term recovery and well-being, improved treatment outcomes, and reduce disparities in cancer survivorship. Not addressing both may create a cycle of vulnerability, particularly among older and underserved populations.

This study was designed to answer the following research questions:

a.Is there a difference in mental health (depression and anxiety rates) between those with and without a prostate cancer diagnosis?

b.Is there a difference in mental health screening (symptoms of depression and anxiety) between those with and without a prostate cancer diagnosis?

c.Does food security status differ between individuals with and without a prostate cancer diagnosis?

2. Methodology

This study utilized secondary data from the 2023 National Health Interview Survey (NHIS) database [42].

2.1. Participants and Data Collection

2.2. Prostate Cancer Diagnosis

Prostate cancer diagnosis was determined by the question, “Have you ever been told by a doctor or other health professional that you had prostate cancer?” Responses were dichotomized as “Yes” or “No.”

2.3. Food Security Status

Food security was assessed using four statements regarding overall food security, worry that food would run out, ability to afford to eat balanced meals, and whether food bought lasted during the last 30 days. For example, one of the statements was, “I/We worried whether my/our food would run out before I/we got money to buy more. Was that often true, sometimes true, or never true for you/your family in the last 30 days?”

2.4. Mental Health Status

2.4.1. Confirmed Diagnosis of Depression and Anxiety

Individuals were asked to self-report their diagnosis of depression or anxiety by answering the following questions: “Have you ever been told by a doctor or other health professional that you had any type of depression” and “Have you ever been told by a doctor or other health professional that you had any type of anxiety disorder?” Responses for both questions were dichotomized as “Yes” or “No.”

2.4.2. Screening for Depression and Anxiety (PHQ-4)

Mental health was assessed using Patient Health Questionnaire-4 (PHQ-4) scores to evaluate symptoms of anxiety and depression [43]. The PHQ-4 is a validated screening tool comprising four questions related to psychological well-being. The first two items of the PHQ-4 assess anxiety by evaluating feelings of nervousness and excessive worry. The third and fourth items focus on symptoms of depression, specifically feelings of hopelessness and lack of interest or pleasure in daily activities. Sample questions include “Over the last two weeks, how often have you been bothered by...little interest or pleasure in doing things” and “Over the last two weeks, how often have you been bothered by...not being able to stop or control worrying?” Responses were recorded using a Likert scale ranging from (1) “Not at all” to (4) “Almost every day,” with a combined value of 4 points. A total score of ≥3 for the first two questions suggests anxiety, while scores of ≥3 for the last two questions suggest depression.

2.4.3. Medication Uses for Depression and Anxiety

Participants were asked two questions relating to medication use for depression and anxiety (Do you take prescription medication for depression? Do you take prescription medication for anxiety?). Responses were dichotomized as “Yes” or “No.”

2.4.4. Cigarette Smoking Status

Smoking status (current, former, never) was determined by responses to questions about cigarette and e-cigarette usage.

2.6. Data Analysis

NHIS is a complex household survey for which the analysis needs to consider key design features: sampling units, sampling stratification, and sampling weights [44]. Accordingly, summary statistics and statistical analyzes were produced using the survey package [44] within the R version 4.3.3 computing environment [45]. The adult male subsample was summarized by cross-tabulating demographics (age, race/ethnicity, education, family poverty ratio, BMI and marital status) with prostate cancer indicated (yes/no); the chi-squared test of independence was used to assess the association with each demographic. The binary depression/anxiety and associated medication use variables were analyzed using a logistic regression model that included prostate cancer as a covariate. A similar logistic regression model was used to analyze binary food security variables.

As this study was exploratory in nature, no adjustment for multiple comparisons was planned or implemented. No imputations of missing data were used; only observed data were analyzed. P-values< 0.05 were considered statistically significant.

3. Results

Table 1. Percentage of Men with Prostate Cancer, by Demographics

Table 2 shows the observed percentages for depression, anxiety, medication use, and smoking status among men with and without prostate cancer. Rates of diagnosed depression and anxiety were similar for among men with and without prostate cancer. In the sample, 13.6% of men diagnosed with prostate cancer reported that they were diagnosed with depression compared to 13.7% of those who did not have prostate cancer. Similarly, 12.8% of men diagnosed with prostate cancer were diagnosed with anxiety compared to 12.9% of those who did not have prostate cancer. After responding to the PHQ-4, rates were similar for men with and without prostate cancer. Therefore, there was no statistically significant difference in the rates of depression and anxiety diagnoses, or in screening for these conditions, between men with and without prostate cancer. However, men who were diagnosed with prostate cancer were statistically more likely to take medication for depression (10.3%) compared to men who with no cancer diagnosis (10.3% vs. 7.3%; p = 0.036).

Table 3 presents food security outcomes among men with and without prostate cancer. Overall food security was significantly associated with cancer diagnosis. For example, men who had prostate cancer were more food secure than those without prostate cancer (95.2% vs. 92.1%; p = 0.037). They were also more likely to have sufficient food to last them (p = 0.0410) compared to those without cancer.

Table 2. Observed Percentages for Depression/Anxiety, Medication Use, and Smoking Status by Prostate Cancer, among Adult Men

Table 3. Observed Percentages for Food Security Outcomes, by Prostate Cancer, among Adult Men

4. Discussion

This study examined factors among men with and without a prostate cancer diagnosis to determine if there is a difference in food security and mental health well-being such as anxiety and depression. Prostate cancer is one of the most common diagnoses among men in the United States and is prevalent in men 64 and older. One in eight men will be diagnosed with prostate cancer during their lifetime yet only 1 in 44 will die from prostate cancer, suggesting a high survival rate. However, prostate cancer is much more prevalent among Black and Hispanic men than among their white counterparts, suggesting that Black and Hispanic men receive a diagnosis much later in their prostate cancer trajectory [7].

This research found some associations in men with prostate cancer and their mental health, food security status, smoking behaviors, and taking depression medications. For example, [46] found an association between cigarette smoking and prostate cancer development. In our study, we saw a statistically significant difference in the number of prostate cancer patients who were former smokers (p = 0.028) compared to those who were not smokers. Additionally, those who had prostate cancer had a higher rate of anxiety and depression. Notably, there was some significance in patients with prostate cancer who took medication for their depression (p = 0.036). According to [47], the addition of hormone therapy is associated with an increased risk of anxiety and depression in men with a prostate cancer diagnosis. Reference [48] found that prostate cancer patients often struggle with increased anxiety and depression due to the psychological toll of their diagnosis. Also, [6] pointed out that mental health challenges are particularly prevalent among African American men, who face additional barriers in coping with both their diagnosis and its mental health effects. Furthermore, [49] highlighted that Black men experience even greater mental health challenges after a prostate cancer diagnosis, which worsens existing health disparities. These sources point to a clear need for mental health support for men with prostate cancer, as they are more likely to face depression and anxiety than those without the disease.

The NHIS data provided some insights into the demographics of patients with and without prostate cancer concerning their education and food security status. Unsurprisingly, prostate cancer patients with a bachelor’s degree or higher had better food security than those without. On the other hand, those with less than a high school education were 76% more likely to be food insecure. However, this research found no significant difference between participants with and without prostate cancer.

While food security is a good predictor of quality of care. Our research indicates that men with prostate cancer were more food secure than those without prostate cancer, even among those who did not receive food stamps. For example, men who had prostate cancer experienced higher overall food security (p = 0.037), could afford to eat a balanced meal (p = 0.030), and over the past 30 days, their food lasted (p = 0.041). These findings are contrary to previous reports, where patients with cancer are usually more food insecure than non-cancer patients [27,50]. Possible explanations for these results may indicate interventions by cancer treatment centers and advocacy groups to provide food assistance for people with cancer [27,51] and increased screening for people who could benefit from government assistance. These are additional services that help to treat the patient as a whole person; not just their condition. In addition, patients may have access to local food pantries in their communities to secure food. These are additional services that support a more holistic approach to patient care by providing access to resources that help maintain food security despite their diagnosis.

Mental health screening revealed no statistically significant differences in depression and anxiety symptoms between men with and without prostate cancer. Men with prostate cancer screened 5.8% positive for depression compared to 6.5% without (p = 0.609). For anxiety, 5.6% of prostate cancer patients screened positive versus 7.4% of those without (p = 0.246). These findings contrast with existing literature pointing out the high prevalence of psychological distress in prostate cancer patients. Approximately 39.3% of men with prostate cancer experience depression symptoms while 28% face anxiety before beginning treatment [9]. The prevalence of anxiety one year after diagnosis increased slightly from 7.8% to 8.5% while depression rates doubled from 3.1% to 6.8% [8]. Prostate cancer has a lasting psychological impact, which comes with the stress of diagnosis, treatment, and potential side effects [3,8,9].

The discrepancy between these NHIS findings and those of previous studies may be attributed to differences in screening tools, timing of assessments, or clinical settings. Whereas the PHQ-4 is a brief, general screening tool used in broad public health surveys [43], prior studies often had more detailed, cancer-specific psychiatric assessments conducted at critical emotional time frames like diagnosis or beginning of treatment. These methodological differences affect symptom detection rates. Timing also matters with assessments taken long after diagnosis and treatment plans [8]. Despite the lack of statistical difference in PHQ-4 symptom prevalence, higher medication use for depression and anxiety among men with prostate cancer suggests that mental health concerns in this group are still being recognized and managed in clinical settings. This pattern may indicate that healthcare providers are more vigilant about the emotional impact of cancer, prompting earlier or more frequent treatment interventions even when screening tools do not show significant symptom differences [3,36].

Even though PHQ-4 screening data from the NHIS did not reveal statistically significant differences in depression and anxiety symptoms between men with and without prostate cancer, findings confirm the substantial emotional burden associated with prostate cancer [8,9]. Differences in measurement tools, assessment timing, and study settings likely contribute to this observed gap [3]. The higher use of mental health medications among prostate cancer patients is proof that psychological problems are being addressed in the clinical process [36]. Efforts to improve screening sensitivity and mental health integration in cancer care are essential to support the psychological needs of this population [3,9].

Among all cancer survivors, prostate cancer patients were least likely to report differences in access to food. The fact that the NHIS participants reported they were not having any issues with providing food for themselves and their families is an interesting result. The difference could be explained by the higher numbers of participants in the NHIS study (nationwide) while [36] only analyzed (N = 368) participants comprising cancer survivors from the New Mexico Tumor Registry and included adults over age 65 who had known associations between aging and the financial problems that came with aging. Importantly, the results were also self-reported, and no face-to-face interviews were conducted. Participants completed either a paper survey, a web-based survey, or a telephone survey.

4.1. Limitations

While the NHIS database is large and representative of the US population, we found a few limitations due to the low number of participants (483) who reported a diagnosis of prostate cancer. Because the NHIS relies on self-reporting, there might be participant recall bias. This may be particularly evident in remembering the questions related to food security. The PHQ-4 is another area where there may be participant recall bias in remembering key elements that point to anxiety or depression. Although the PHQ-4 has had remarkable validity, it is still subject to self-reporting and is seen as a limitation. Additionally, we were unable to access data to determine if there was a difference in location rural versus urban. Perhaps those in rural locations do not have ready access to screening due to location, lack of transportation, and/or lack of providers.

4.2. Implication for Practice

The survival rate of men with prostate cancer in the United States has been positive with early detection and early interventions; yet Black and Hispanic men continue to experience delay in early diagnosis and intervention due to perceptions about masculinity, distrust of the healthcare system, financial or insurance issues, and spiritual and religious beliefs [52,53]. This suggests a need for increased awareness for men in these racial/ethnic groups. Since the research suggests that mental health is also impacted by a prostate cancer diagnosis, it is equally important to conduct early screening of mental health vitality.

Improvement in mental health is likely to have an overall impact of the health and well-being of patients diagnosed with prostate cancer. Early screenings and early interventions should be culturally and linguistically appropriate with ethnically matched providers to improve the successful treatment and survival rates of the most vulnerable. Healthcare providers and community health professionals must aim to engage in culturally and linguistically sensitive community and faith-based education initiatives.

Expansion of mental health services specifically designed for cancer patients should include initiatives from the American Psychological Association (APA), the National Alliance on Mental Illness (NAMI), and the Black Men’s Prostate Cancer Initiative, which promotes literacy assessments, support groups, podcast series, and film series in locations where these vulnerable populations may congregate, like barbershops or pool halls. Improving access to these services can help reduce the psychological toll of prostate cancer diagnosis.

5. Conclusion

The link between prostate cancer, food security, and mental health is revealing. Men with prostate cancer generally experience better food security compared to men without prostate cancer. Much of this can be explained with higher education, being married, and taking medication to minimize anxiety and depressive symptoms. We noted in this discussion that early diagnosis and early interventions for prostate cancer will increase the quality of life of men in the United States. This is particularly important for Black and Hispanic men, who seem to receive diagnoses later than their white counterparts. We also acknowledge in this discussion that prostate cancer diagnosis takes a mental and emotional toll on patients, and with this comes anxiety and depression. Finally, our findings reveal that men with prostate cancer experience better food security and were more likely to use medications for depression compared to those without prostate cancer. They were also more likely to be Black/African America, older, overweight, and married.

5.1. Recommendations

To address the persistent disparities in prostate cancer outcomes among Black and Hispanic men in the United States, a multifaceted and culturally responsive approach is essential. Our research team makes several recommendations. They are in no specific order and are all equally important.

To reach this population of Black and Hispanic men, we recommend promoting early detection through culturally tailored campaigns that take advantage of multiple strategies to include culturally and linguistically relevant language that appropriately reflects the values, beliefs, and health behaviors of this population. Further, we recommend that health information be provided at the sixth-grade level [54] that reflects both English and Spanish, ensuring that translation in the Spanish language accounts for the various dialects that are nuanced in the Spanish language.

We also believe a campaign is not complete without addressing the cultural and historical barriers that contribute to mistrust in healthcare systems. Any healthcare campaign should recognize these facts in written documents and provide evidence of building trusting relationships between patients and providers. This could be as simple as adding community health workers or patient navigators to the team. Lastly, we recommend that men should be active and promote healthy weights throughout life, avoid cigarette/e-cigarette smoking, and get psychological support once diagnosed with prostate cancer.

ACKNOWLEDGEMENTS

We want to thank Dr. John Orazem for assisting us with the data analysis of the NHIS data set.

References

[1]   | American Cancer Society. “Key statistics for prostate cancer,” American Cancer Society, 2025. [Online]. Available: https:// www.cancer.org/ cancer/ types/ prostate-cancer/ about/key-statistics.html.
[2]   | Lowder, D., Rizwan, K., McColl, C., Paparella, A., Ittmann, M., Mitsiades, N., and Kaochar, S., “Racial disparities in prostate cancer: a complex interplay between socioeconomic inequities and genomics,” Cancer Letters, 531, 71-82, 2022.

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[5]   | Hage Chehade C, Agarwal N. “Racial and ethnic disparities in prostate cancer-correlation with incidence and progression.” JAMA 7 (11):e2445522. 2024.
[6]   | Centers for Disease Control and Prevention. “Prostate cancer risk factors” August 2024. .
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