Ethnic variation in return to baseline values of patient-reported outcomes in older prostate cancer patients.
BACKGROUND
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.


METHODS
In this prospective cohort study, between the years 2002 and 2004, the authors recruited 214 older (>or=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.


RESULTS
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.


CONCLUSIONS
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.
Jayadevappa
Ravishankar
R
Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104-2676, USA. jravi@mail.med.upenn.edu
Johnson
Jerry C
JC
Chhatre
Sumedha
S
Wein
Alan J
AJ
Malkowicz
S Bruce
SB
D000203:Activities of Daily Living; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D015331:Cohort Studies; D005006:Ethnicity; D006304:Health Status; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000208:ethnology* / Q000523:psychology / Q000628:therapy; D011788:Quality of Life; D012650:Self Disclosure; D011795:Surveys and Questionnaires; D044465:White People / Q000706:statistics & numerical data*