Socioeconomic status and health-related quality of life among patients with prostate cancer 6 months after radical prostatectomy: a longitudinal analysis.
To identify the associations between socioeconomic status (SES) and health-related quality of life (HRQOL) and the explanatory contribution of disease, patient and healthcare factors among patients with prostate cancer.



Prospective cohort study.



In all, 246 patients from 2 hospitals in Hamburg/Germany who underwent radical prostatectomy completed a questionnaire shortly before discharge from hospital and again 6 months later.



HRQOL as assessed by the European Organisation for Research and Treatment of Cancer (EORTC) QLQ C-30 including global quality of life, 5 functional scales and 9 symptom scales/items. Generalised estimating equations were calculated to analyse longitudinal data.



Lower SES measured by income, education and occupational status is significantly associated with lower HRQOL 6 months after treatment. This especially holds true for the functional scales. After introducing disease, patient and healthcare factors, associations remain significant in the majority of cases. The explanatory contribution of patient factors such as comorbidity or psychosocial characteristics and of healthcare factors is slightly stronger than that of disease factors.



We identified strong social inequalities in HRQOL among patients with prostate cancer 6 months after surgery, in Germany. The underlying causes could not be sufficiently identified, and further research regarding these associations and their explanatory factors is needed.
Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Jens
J
Klein
Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Kerstin
K
Hofreuter-Gätgens
Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Daniel
D
Lüdecke
Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Margit
M
Fisch
Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Markus
M
Graefen
Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Olaf
O
von dem Knesebeck
D015897:Comorbidity; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D054526:Men's Health; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000523:psychology / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery; D011788:Quality of Life; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology* / Q000523:psychology; D012923:Social Class; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000523:psychology
Explanatory factors; Germany; Health-rated quality of life; Prostate cancer; Socioeconomic status