Racial/Ethnic differences in functional outcomes in the 5 years after diagnosis of localized prostate cancer.
OBJECTIVE
We investigated racial/ethnic differences in functional outcomes up to 5 years after diagnosis among men with aggressively treated localized prostate cancer.


METHODS
Patients were from the Prostate Cancer Outcomes Study, a population-based cohort study that surveyed patients at 6, 12, 24, and 60 months after diagnosis. Analyses were stratified by primary treatment. Racial/ethnic differences at each time point were assessed using Generalized Estimating Equations, adjusting for pretreatment function, age at diagnosis, secondary treatment, and other confounders. An adjusted summary score for each functional domain was calculated for each time period.


RESULTS
Patients included 1,475 non-Hispanic white, 321 African-American, and 279 Hispanic prostate cancer patients. After 60 months, among prostatectomy patients, African-Americans had significantly higher sexual function scores than non-Hispanic whites (43.9 v 36.1; P = .02), but were more likely to have a moderate to big problem with sexual function (50.6% v 44.4%; P = .04). African-Americans also had higher urinary function scores at 5 years than non-Hispanic whites (78.5 v 72.4; P = .04) and were less likely to have problems with incontinence. Changes in sexual and bowel function after radiotherapy showed no significant racial/ethnic differences.


CONCLUSIONS
This long-term cohort study found that, among prostatectomy patients, African-Americans had better recovery of sexual and urinary function at 60 months after diagnosis that was likely to be of mild clinical significance, despite reporting more problems with sexual function than non-Hispanic whites. More study is necessary to understand reasons for these differences. In contrast, no racial/ethnic differences in recovery from radiotherapy were found.
Johnson
Terri Kang
TK
University of Southern California Keck School of Medicine, Dept of Preventive Medicine, 1441 Eastlake Ave, Rm 3427A, MC9175, Los Angeles, CA 90089-9175, USA. ahamilt@usc.edu
Gilliland
Frank D
FD
Hoffman
Richard M
RM
Deapen
Dennis
D
Penson
David F
DF
Stanford
Janet L
JL
Albertsen
Peter C
PC
Hamilton
Ann S
AS
D001741:Black or African American; D000368:Aged; D015331:Cohort Studies; D007172:Erectile Dysfunction; D005006:Ethnicity; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects; D011471:Prostatic Neoplasms / Q000208:ethnology* / Q000503:physiopathology*; D014549:Urinary Incontinence; D044465:White People