Comorbidity Prevalence and Impact on Quality of Life in Gay and Bisexual Men Following Prostate Cancer Treatment

Abstract

Introduction: Studies have demonstrated worse health related quality of life (HRQOL) outcomes in gay and bisexual men (GBM) following prostate cancer treatment compared to heterosexual men potentially due to differences in comorbidity burden. Aim: To establish the prevalence of comorbidities and their association with HRQOL metrics in GBM following prostate cancer treatment. Methods: We evaluated HRQOL and prevalence of comorbidities in 193 GBM from the United States and Canada in a cross-sectional, online survey: the Masked for Review. HRQOL was measured with the Expanded Prostate Cancer Index Composite (EPIC) and the 12-Item Short Form Health Survey (SF-12). Main Outcome Measures: Our outcomes included comorbidity prevalence, mean differences for HRQOL scores by comorbidity status, and mean differences for HRQOL by comorbidity count. Results: GBM were found to have a higher prevalence of blood vessel disease and mental health disorders but lower prevalence of obesity and type 2 diabetes when compared to published data in general prostate cancer populations. Statistically significant reductions in HRQOL metrics were associated with mental health diagnoses, diabetes, and obesity. Increased number of comorbidities was also associated with reductions in HRQOL metrics in nearly all categories. Conclusion: These results suggest that the worse QOL outcomes in GBM following prostate cancer treatment may be due to differences in comorbidity burden. This study is the first to evaluate the relationship between comorbidities and HRQOL outcomes in GBM. Limitations of this study include a small sample size and crosssectional study design. If confirmed in larger, longitudinal, clinically confirmed studies, these findings indicate a need to intervene on and consider comorbidities in GBM diagnosed with prostate cancer.

LGBTQI cancer patients’ quality of life and distress: A comparison by gender, sexuality, age, cancer type and geographical remoteness

“…Evidence of greater psycho-social vulnerability of SGM people with cancer is primarily based on research with white cisgender adults, predominantly with breast or prostate cancer (1). It has been reported that gay or bisexual cisgender men with prostate cancer report higher psychological and cancer-related distress and lower quality of life (9)(10)(11)(12)(13)(14), in comparison to heterosexual men. Cisgender breast cancer survivors who identify as lesbian, bisexual or queer (LBQ), report higher levels of distress and lower quality of life than heterosexual women (1,15,16).…”

Prostate Cancer in Sexual Minorities: Epidemiology, Screening and Diagnosis, Treatment, and Quality of Life

“…They can be indicative of overall health-related quality of life in patients dealing with prostate cancer [64]. These questionnaires, however, are focused on heterosexual men and do not adequately capture quality of life outcomes in GBM and TW [51,65].…”

Health and Social Inclusion: The Impact of Psychological Well-Being and Suicide Attempts Among Older Men Who Have Sex With Men

“…Research suggests that social support and interpersonal interactions can decrease depression levels and increase overall levels of quality of life ( Yang et al, 2021 ); depression, especially untreated, can negatively affect the quality of life ( Yan et al, 2022 ; Yang et al., 2021 ). Community members, neighbors, and relatives may provide social support to LGBT older adults ( Haggart et al, 2021 ), increasing the chances of those individuals having a better mental health (lower levels of depression and anxiety) and better quality of life ( Martiana et al, 2021 ).…”