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The effect of race on treatment patterns and subsequent health-related quality of life outcomes in men undergoing treatment for localized prostate cancer

Prostate Cancer and Prostatic Diseases volume 26, pages 415–420 (2023)Cite this article

Subjects

Abstract

Introduction

Racial differences in Health-Related Quality of Life (HRQoL) after treatment of prostate cancer (PCa) are not well studied. We compared treatment patterns and HRQoL in African American (AA) and non-AA men undergoing active surveillance (AS), radical prostatectomy (RP), or radiation (XRT).

Methods

Men diagnosed with PCa from 2007–2017 in the Center for Prostate Disease Research Database were identified. HRQoL was evaluated using Expanded PCa Index Composite and SF-36 Health Survey.

Results

In 1006 men with localized PCa, 223 (22.2%) were AA (mean follow up 5.2 yrs). AA men with low-risk disease were less likely to undergo AS (28.5 vs. 38.8%) and more likely to undergo XRT (22.3 vs. 10.6%) than non-AA men, p < 0.001. In intermediate-risk disease, AA received more XRT (43.0 vs. 26.9%) and less RP (50.5 vs 66.8%), p = 0.016. In all men, RP resulted in worse urinary function and sexual HRQoL compared to AS and XRT. Bowel HRQoL did not vary by treatment in AA men, however, in non-AA men, XRT resulted in worse bowel scores than AS and RP. HRQoL was then compared for each treatment modality. AA men had worse sexual bother (p = 0.024) after RP than non-AA men, No racial differences were found in urinary, bowel, hormonal, or SF-36 scores for men undergoing AS, RP or XRT.

Conclusion

AA men are less often treated with AS for low-risk disease and are more likely to undergo XRT. AA men experience worse sexual bother after RP, however, the effect of XRT on bowel symptoms is worse in non-AA men.

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Data availability

The datasets generated and analyzed in this study are not publicly available due to restrictions imposed by the current IRB protocol but can be made available from the corresponding author upon approval of a separate IRB protocol allowing for their subsequent use.

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Author information

Authors and Affiliations

  1. Virginia Mason Franciscan Health, Seattle, WA, USA

    Natasza M. Posielski, John Paul Flores & Christopher Porter

  2. Walter Reed National Military Medical Center, Bethesda, MD, USA

    Santosh Shanmuga, Gregory T. Chesnut & Timothy Tausch

  3. Institute for Systems Biology, Seattle, WA, USA

    On Ho

  4. Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    Jiji Jiang, Sally Elsamanoudi, Ryan Speir, Sean Stroup, John Musser, Alexander Ernest & Gregory T. Chesnut

  5. The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA

    Jiji Jiang & Sally Elsamanoudi

  6. Madigan Army Medical Center, Tacoma, WA, USA

    Ryan Speir

  7. Naval Medical Center, San Diego, CA, USA

    Sean Stroup

  8. Tripler Army Medical Center, Honolulu, HI, USA

    John Musser

  9. Brooke Army Medical Center, Fort Sam Houston, Houston, TX, USA

    Alexander Ernest

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Contributions

NP contributed to conceptualization, methodology, validation, writing original draft, and manuscript review and editing. SS contributed to writing original draft, and manuscript review and editing. OH contributed to conceptualization and methodology. JJ contributed to data curation, formal analysis, investigation, project administration, validation, visualization and manuscript review and editing. SE contributed to data curation, formal analysis, investigation, project administration, validation, visualization and manuscript review and editing. RS contributed to manuscript review and editing. SS contributed to manuscript review and editing. JM contributed to manuscript review and editing. AE contributed to manuscript review and editing. GC contributed to manuscript review and editing. TT contributed to manuscript review and editing. JPF contributed to conceptualization, methodology, validation, and manuscript review and editing. CP contributed to conceptualization, methodology, validation, and manuscript review and editing.

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Correspondence to Natasza M. Posielski.

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Posielski, N.M., Shanmuga, S., Ho, O. et al. The effect of race on treatment patterns and subsequent health-related quality of life outcomes in men undergoing treatment for localized prostate cancer. Prostate Cancer Prostatic Dis 26, 415–420 (2023). https://doi.org/10.1038/s41391-022-00608-4

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