Impact of diagnosis and treatment of clinically localized prostate cancer on health-related quality of life for older Americans

A population-based study

Authors

  • Bryce B. Reeve PhD,

    Corresponding author
    1. Lineberger Comprehensive Cancer Center; Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
    • 135 Dauer Drive, 1101-D McGavran-Greenberg Building, Chapel Hill, NC 27599-7411
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    • Fax: (919) 843-6362

  • Angela M. Stover MA,

    1. Department of Health Behavior and Health Education, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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  • Roxanne E. Jensen PhD,

    1. Cancer Control Program, Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
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  • Ronald C. Chen MD, MPH,

    1. Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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  • Kathryn L. Taylor PhD,

    1. Cancer Control Program, Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
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  • Steven B. Clauser PhD,

    1. Outcomes Research Branch, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
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  • Sean P. Collins MD, PhD,

    1. Department of Radiation Oncology, Georgetown University Hospital, Washington, DC
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  • Arnold L. Potosky PhD

    1. Cancer Control Program, Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
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Abstract

BACKGROUND:

Few studies have measured longitudinal changes in health-related quality of life (HRQOL) among patients with prostate cancer starting before their cancer diagnosis or have provided simultaneous comparisons with a matched noncancer cohort. In the current study, the authors addressed these gaps by providing unique estimates of the effects of a cancer diagnosis on HRQOL accounting for the confounding effects of ageing and comorbidity.

METHODS:

Data from the Surveillance, Epidemiology, and End Results registry were linked with Medicare Health Outcomes Survey (MHOS) data. Eligible patients (n = 445) were Medicare beneficiaries aged ≥65 years from 1998 to 2003 whose first prostate cancer diagnosis occurred between their baseline and follow-up MHOS. By using propensity score matching, 2225 participants without cancer were identified from the MHOS data. Analysis of covariance models were used to estimate changes in HRQOL as assessed with the Medical Outcomes Study Short Form-36 survey and the activities of daily living scale.

RESULTS:

Before diagnosis, patients with prostate cancer reported HRQOL similar to that of men without cancer. After diagnosis, men with prostate cancer experienced significant decrements in physical, mental, and social aspects of their lives relative to controls, especially within the first 6 months after diagnosis. For men who were surveyed beyond 1 year after diagnosis, HRQOL was similar to that for controls. However, an increased risk for major depressive disorder was observed among men who received either conservative management or external beam radiation.

CONCLUSIONS:

The current findings illustrated the time-sensitive nature of decline in HRQOL after a cancer diagnosis and enhanced understanding of the impact of prostate cancer diagnosis and treatment on physical, mental, and social well being among older men. Cancer 2012. © 2012 American Cancer Society.

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