Treatment decisional regret among men with prostate cancer: Racial differences and influential factors in the North Carolina Health Access and Prostate Cancer Treatment Project (HCaP-NC).
BACKGROUND
It has been demonstrated that treatment decisional regret affects quality of life in patients with prostate cancer (CaP); however, there are limited studies that identify factors associated with treatment decisional regret, particularly within a racially diverse patient population that has extended follow-up.


METHODS
Logistic regression analysis was used to determine associations between decisional regret and potential predictors in a population-based cohort of 348 African American men and 446 Caucasian American men approximately 3 years after CaP diagnosis.


RESULTS
Of 794 research participants, 12% experienced treatment decisional regret. Decisional regret was associated with androgen-deprivation therapy (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.1-4.0), recent urinary bother (OR, 3.4; 95% CI, 1.6-7.3), satisfaction with understanding potential treatment side effects (very unsatisfied: OR, 13.3; 95% CI, 5.5-32.2; somewhat unsatisfied: OR, 5.0; 95% CI, 2.3-11.2; neutral: OR, 3.8; 95% CI, 1.9-7.6), and CaP treatment effect on the spousal relationship (very affected: OR, 3.9; 95% CI, 2.0-7.6; somewhat affected: OR, 3.1; 95% CI, 1.4-7.3; neutral: OR, 2.4; 95% CI, 1.9-7.6). Younger African Americans were more likely to experience regret than older African Americans (OR, 3.0; 95% CI, 1.1-8.1), and older African Americans were less likely to experience regret than older Caucasian Americans (OR, 0.2; 95% CI, 0.1-0.7).


CONCLUSIONS
Treatment decisional regret remains an important issue in CaP survivors beyond initial treatment. Potential interventions should involve younger African Americans and patient spouses. Increased regret may reflect the unexpected influence of treatment side effects on the patient's everyday life; helping the patient relate potential side effects to his individual situation could improve patient satisfaction.
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.|Baptist Hospital Comprehensive Cancer Center, Wake Forest University, Winston-Salem, North Carolina.
Bonny B
BB
Morris
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Laura
L
Farnan
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.|School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Lixin
L
Song
Clinical Health Psychology, University of North Carolina at Charlotte, Charlotte, North Carolina.
Elizabeth L
EL
Addington
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.|Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Ronald C
RC
Chen
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.|Department of Surgery/Urology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Matthew E
ME
Nielsen
School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Merle
M
Mishel
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.|Department of Surgery/Urology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.|Department of Urology, Roswell Park Cancer Institute, Buffalo, New York.|Department of Urology, University of Buffalo School of Medicine and Biotechnology, Buffalo, New York.
James L
JL
Mohler
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.|Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Jeannette T
JT
Bensen
D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D003657:Decision Making; D006297:Health Services Accessibility; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D017060:Patient Satisfaction; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D063505:Racism; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D044465:White People / Q000523:psychology* / Q000706:statistics & numerical data
African Americans; emotions; health status disparities; prostatic neoplasms; quality of life; spouses