Gender-based Differences in Psychosocial Well-being Among Bladder Cancer Survivors

While gender disparities in bladder cancer are well documented in sexual and functional health domains, mental and social well-being among survivors are not elucidated fully. We aimed to investigate gender differences in mental well-being, social connectedness, and perceptions of respect among bladder cancer survivors.

We conducted a cross-sectional analysis from the All of Us Research Program of the National Institutes of Health, a nationwide cohort integrating survey responses and electronic health records (EHRs). Individuals with a diagnosis of malignant neoplasm of the bladder were included. The primary outcomes were self-reported overall mental and social health and EHR-documented depressive disorder. Multivariable logistic regression was adjusted for age, race, education/marital status, time since diagnosis, and comorbidities.

Among 1085 individuals diagnosed with bladder cancer (319 women and 766 men), women had significantly higher odds of EHR-documented depressive disorder than men (adjusted odds ratio [interquartile range]: 2.86 [1.59, 3.82]; p < 0.001). A higher proportion of women reported lacking companionship (p = 0.007), feeling isolated (p = 0.025), experiencing stress (p < 0.001), and inability to cope (p < 0.001). Female scores for general mental and social health were decreased but were not significantly different after adjusting for covariates. No gender differences were observed in perceived respect/courtesy from health care providers.

Women with bladder cancer experience disproportionate psychosocial burden compared with men, particularly related to depression and social isolation. Certain disparities were not apparent after adjustment for socioeconomic factors and comorbidities, underscoring the need to support patients with predisposing factors to adverse mental outcomes. Routine psychosocial screening should be integrated into bladder cancer survivorship to identify and support vulnerable individuals.