Jayadevappa R, Chhatre S, Johnson K, Bloom B, Malkowicz B; AcademyHealth. Meeting (2004 : San Diego, Calif.).
Abstr AcademyHealth Meet. 2004; 21: abstract no. 1924.
University of Pennsylvania, Department of Medicine, 224, Ralston-Penn Center, 3615 Chestnut Street, Philadelphia, PA 19103-8684 Tel. 215.898.3798 Fax 215.573.8684
RESEARCH OBJECTIVE: Quality of life has become an integral part of cancer outcome research. Multiple factors (demographic, clinical, social and economic) influence the Health Related Quality of Life (HRQoL) and must be assessed for effective management and treatment of diverse prostate cancer (PC) patients. Little information is available regarding effects of differential treatment patterns for ethnic or age groups on quality of life of newly diagnosed PC patients. The objective of this study is to analyze the variations in HRQoL of newly diagnosed PC patients by ethnicity and age over a 3-month follow-up. STUDY DESIGN: For this prospective study, we recruited 316 newly diagnosed PC patients from the urology clinics of an urban academic hospital and Veterans Administration hospital. Participants completed SF-36 and UCLA-PCI surveys prior to their treatment, and at 3-month follow-up. Demographics and HRQoL were compared across ethnicity using t-test and chi-sq. Log linear regression model was used to assess factors associated with general and PC-specific HRQoL. Independent variables were age, ethnicity, treatment facility, income, marital and surgical status. POPULATION STUDIED: PRINCIPAL FINDINGS: Caucasians (C) had significantly higher income, education and were more likely employed. For Caucasians there was no significant variation in education by age (some college or greater: <65 C = 75.2%, = >65 C = 73.81%), however African Americans (AA) showed significant variation (among <65 AA, 51.11% had some college or greater; in the = >65 AA, 80% were high school graduates). Caucasians and AA showed no important variation in marital status by age, however more AA lived alone than Caucasians. Type of treatment varied significantly across ethnicity; more Caucasians received surgery (71.25% C vs. 44.19% AA, p = .0009) whereas more AA received radiation treatment (13.13% C vs. 25.58% AA, p = .047). Baseline mean scores of general HRQoL demonstrated that AA were substantially less healthy by all physical, psychological and social measures. The PC-specific HRQoL did not differ by ethnicity. At 3-months, general HRQoL scores remained significantly higher for Caucasians except for vitality, mental health, and social function. The mean scores for both groups in general HRQoL and PC QoL declined from baseline levels, though the groups relative divergence narrowed. PC-specific QoL demonstrated important differences by ethnicity. Caucasians reported significantly greater bowel function (87.86 C vs. 81.47 AA, p = 0.02) and less bowel bother (88.75 C vs. 78.41 AA, p = 0.006), while AA reported significantly greater sexual function (20.74 C vs. 29.06 AA, p = 0.045). Regression analysis for baseline data indicated that income and presence of other illnesses were significantly positively associated with general health and physical function. Regression analysis for the 3-month follow-up data indicated that patients receiving surgery demonstrated significant negative association with urinary function. CONCLUSIONS: Variations exist at baseline characteristics and HRQoL of newly diagnosed PC patients by ethnicity. At 3-month, the variations in HRQoL by ethnicity narrowed as HRQol for both the ethnic groups declined. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: Assessment of HRQoL and comorbidities is crucial for effective management of PC.
Publication Types:
Keywords:
- African Americans
- Comorbidity
- Demography
- Educational Status
- Ethnic Groups
- European Continental Ancestry Group
- Humans
- Income
- Life
- Male
- Marital Status
- Mental Health
- Population Groups
- Prospective Studies
- Prostatic Neoplasms
- Quality of Life
- hsrmtgs
UI: 103624958
From Meeting Abstracts