Background: Ethnic variation in patient-reported outcomes such as health-related quality of life (HRQoL) and satisfaction with care are understudied areas in the management of elderly prostate cancer (PCa) patients.
Methods: In this prospective cohort study, between the years 2002 and 2004, the authors recruited 214 older (>or=65 years) men with newly diagnosed PCa from an urban academic hospital and a Veterans Administration hospital. Participants completed generic (SF-36), prostate-specific (UCLA-PCI) HRQoL, and satisfaction with care (CSQ-8) surveys at baseline and at 3, 6, and 12-months follow-up. Clinically significant difference was used to compute return to baseline. The authors compared time to return to baseline HRQoL after controlling for confounding variables by using ANOVA and log-linear models. Survival curves were used to compare time to return to baseline across ethnicity.
Results: Regression analysis revealed that age and marital status, not ethnicity, were independent predictors of radical prostatectomy, rather than radiation treatment. African Americans reported lower HRQoL scores at diagnosis and required a longer time to return to baseline. Log-linear analysis indicated that African-American ethnicity was associated with lower 12-month scores for role physical (odds ratio [OR], 0.46; standard error [SE], 0.40), role emotional (OR, 0.37; SE, 0.43), bodily pain (OR, 0.74; SE, 0.10), urinary function (OR, 0.90; SE, 0.11), and urinary bother (OR, 0.72; SE, 0.17). Both groups reported comparably high levels of satisfaction with care.
Conclusions: African-American elderly exhibited poorer outcomes and required a longer time to return to baseline HRQoL. These differences highlight the need for discussion with patients and families prior to treatment about expectations and the need for support services post-treatment.
(c) 2007 American Cancer Society.