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Ethnic variation in return to baseline values of patient-reported outcomes in older prostate cancer patients
Version of Record online: 18 APR 2007
Copyright © 2007 American Cancer Society
Volume 109, Issue 11, pages 2229–2238, 1 June 2007
How to Cite
Jayadevappa, R., Johnson, J. C., Chhatre, S., Wein, A. J. and Malkowicz, S. B. (2007), Ethnic variation in return to baseline values of patient-reported outcomes in older prostate cancer patients. Cancer, 109: 2229–2238. doi: 10.1002/cncr.22675
- Issue online: 18 MAY 2007
- Version of Record online: 18 APR 2007
- Manuscript Accepted: 12 FEB 2007
- Manuscript Revised: 8 FEB 2007
- Manuscript Received: 22 NOV 2006
- Department of Defense prostate cancer Research Program. Grant Number: DAMD17-02-1-0126
- Joel Appel Cancer Research Fund
- patient-reported outcome;
- clinically important difference;
- minimally important difference;
- health-related quality of life;
- satisfaction with care
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.
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.
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.
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.