Ethnic variation in return to baseline values of patient‐reported outcomes in older prostate cancer patients

Abstract

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 (≥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. Cancer 2007. © 2007 American Cancer Society.

Impact of A118G Polymorphism on the Mu Opioid Receptor Function in Pain

“…Moreover, clinical studies revealed ethnic background as a crucial determinant in analgesic requirements in several pain states such as post-operative [15], chronic [45,46] and cancer pain [47,48]. On the other hand, the duration of opioids analgesia is different among patients with different ethnic backgrounds [49].…”

The Quality-of-Life Impact of Prostate Cancer Treatments

“…Jayadevappa et al [32] conducted a prospective study evaluating QOL and satisfaction with care after RP or RT. Compared with white patients, black patients were less likely to choose RP as primary treatment, although when statistically controlled, ethnicity was not associated with treatment type in statistical significance.…”

The Differences in Quality of Life in Prostate Cancer Project: Methods and Design of a Multidisciplinary Population-Based Follow-up Study

“…Furthermore, alterations in HRQoL have been found to persist even many years after PCa treatment (Sanda et al, 2008;Litwin et al, 2001). Alterations in HRQoL in PCa survivors are not completely dependent on choosing treatments: studies have shown that HRQoL is also associated with stage of cancer at diagnosis, socioeconomic, physical and psychological status, comorbidities, HRQoL prior to diagnosis and health care utilization behaviors (Penedo et al, 2006;Jayadeyappa et al, 2007;Lubeck et al, 2001;Litwin et al, 2001;Ramsey et al, 2007;Penson et al, 2001).…”

“…As with morbidity, there is also a disparity in HRQoL between AA and CA survivors (Penedo et al, 2006;Sanda et al, 2008;Litwin et al, 1999;Jayadeyappa et al, 2007;Lubeck et al, 2001;Johnson et al, 2004;Freedland and Isaacs, 2005;Jenkins et al, 2004;Eton et al, 2001). Though variance in PCa treatment is thought to play a role in this disparity, it has been postulated that AA PCa survivors have lower HRQoL measurements due to lower pretreatment HRQoL, less advantageous sociodemographic characteristics, higher rate of comorbidities, later stage of disease at diagnosis and more issues regarding health care (Penedo et al, 2006;Jayadeyappa et al, 2007;Lubeck et al, 2001;Litwin et al, 2000Ramsey et al, 2007Penson et al, 2001).…”

“…Though variance in PCa treatment is thought to play a role in this disparity, it has been postulated that AA PCa survivors have lower HRQoL measurements due to lower pretreatment HRQoL, less advantageous sociodemographic characteristics, higher rate of comorbidities, later stage of disease at diagnosis and more issues regarding health care (Penedo et al, 2006;Jayadeyappa et al, 2007;Lubeck et al, 2001;Litwin et al, 2000Ramsey et al, 2007Penson et al, 2001). However, previous testing of these hypotheses has generally involved only small AA PCa survivor samples, limiting the conclusiveness of the results (Potosky et al, 2000;Schroeder et al, 2006).…”