Education predicts quality of life among men with prostate cancer cared for in the Department of Veterans Affairs: a longitudinal quality of life analysis from CaPSURE.
BACKGROUND
Previous findings have suggested that patient educational attainment is related to cancer stage at presentation and treatment for localized prostate cancer, but there is little information on education and quality of life outcomes. Patient education level and quality of life were examined among men diagnosed with prostate cancer and cared for within an equal-access health care system, the Department of Veterans Affairs Veterans Health Administration (VA).


METHODS
Participants were 248 men with prostate cancer cared for in the VA and enrolled in CaPSURE. Repeated-measures analysis of variance was used to examine quality of life over time according to education level, controlling for age, ethnicity, income, site of clinical care, and year of diagnosis.


RESULTS
Patients with lower levels of education tended to be younger, nonwhite, and have lower incomes. Controlling for age, ethnicity, income, year of diagnosis, and site, men with less formal education, compared with those with more, had worse functioning in the physical (P=.0248), role physical (P=.0048), role emotional (P=.0089), vitality (P=.0034), mental health (P=.0054), social function (P=.0056), and general health (P=.0002) domains and worse urinary (P=.003) and sexual (P=.0467) side effects.


CONCLUSIONS
Men with less education experienced worse health-related quality of life across a wide range of domains and greater urinary and sexual symptoms than their peers who had more education. Clinicians should be aware that, even within an equal access to health care system, men with less education are vulnerable, having greater difficulty functioning in their daily lives after their prostate cancer treatment.
Knight
Sara J
SJ
San Francisco VA Medical Center, Department of Psychiatry, University of California, San Francisco, California 94121, USA. sara.knight@ucsf.edu
Latini
David M
DM
Hart
Stacey L
SL
Sadetsky
Natalia
N
Kane
Christopher J
CJ
DuChane
Janeen
J
Carroll
Peter R
PR
D000328:Adult; D000368:Aged; D004522:Educational Status; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000473:pathology / Q000523:psychology*; D011788:Quality of Life; D012959:Socioeconomic Factors; D014481:United States; D014493:United States Department of Veterans Affairs