title: Ethnic variation in health-related quality of life among low-income men with prostate cancer.
abstract: OBJECTIVE
  To describe and compare health-related quality of life (HRQOL) among Hispanic, African-American, and Caucasian men with localized prostate cancer.
  
  
  METHODS
  Observational study of low-income, ethnically diverse men with non-metastatic prostate cancer.
  
  
  METHODS
  Statewide public assistance program in California.
  
  
  METHODS
  208 men (51 Caucasian, 115 Hispanic, and 42 African-American men) with non-metastatic disease.
  
  
  METHODS
  Radical retropubic prostatectomy, radiation therapy, and hormonal therapy.
  
  
  METHODS
  Validated instruments measured general and disease-specific HRQOL, anxiety and fear of recurrence, spirituality, symptom distress, and self-efficacy.
  
  
  RESULTS
  Hispanic men with prostate cancer were less educated, more often in significant relationships, and had more variable incomes compared with men of other ethnic/racial backgrounds. In univariate analyses, Caucasian men reported better physical function but less spirituality, while Hispanic men reported worse sexual function. Multivariate analysis revealed that Hispanic men had significantly worse physical function, bowel function, and bowel bother. African-American men experienced greater anxiety over recurrence. African-American and Hispanic men were more spiritual than Caucasian men.
  
  
  CONCLUSIONS
  Greater attention to demographic variations in HRQOL may allow physicians to improve outcomes across ethnicities in low-income men with prostate cancer by offering more specialized counseling and providing referral to social support systems.
authors.affiliation: Department of Urology, David Geffen School of Medicine and School of Public Health, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, USA. tkrupski@mednet.ucla.edu
authors.forename: Tracey L
authors.initials: TL
authors.lastname: Krupski
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Sonn
authors.forename: Lorna
authors.initials: L
authors.lastname: Kwan
authors.forename: Sally
authors.initials: S
authors.lastname: Maliski
authors.forename: Arlene
authors.initials: A
authors.lastname: Fink
authors.forename: Mark S
authors.initials: MS
authors.lastname: Litwin
mesh_terms: D000223:Adaptation, Psychological; D001741:Black or African American / Q000523:psychology; D000368:Aged; D002140:California; D005006:Ethnicity / Q000706:statistics & numerical data; D006304:Health Status; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011203:Poverty; D011471:Prostatic Neoplasms / Q000534:rehabilitation* / Q000628:therapy; D011788:Quality of Life; D044465:White People / Q000523:psychology