Ethnic Variation in Health-Related Quality of Life Among Low-Income Men with Prostate Cancer

OBJECTIVE: To describe and compare health related quality of life (HRQOL) among Hispanic, African-American, and Caucasian men with localized prostate cancer. DESIGN: Observational study of low-income, ethnically diverse men with non-metastatic prostate cancer. SETTING: Statewide public assistance program in California. PARTICIPANTS: 208 men (51 Caucasian, 115 Hispanic, and 42 African-American men) with non-metastatic disease. INTERVENTIONS: Radical retropubic prostatectomy, radiation therapy, and hormonal therapy. MAIN OUTCOME MEASURES: Validated instruments measured general and disease-specific HRQOL, anxiety and fear of recurrence, spirituality, symptom distress, and self-efficacy. RESULTS: Hispanic men with prostate cancer were less educated, more often in significant relationships, and had more variable incomes compared with men of other ethnic/racial backgrounds. In univariate analyses, Caucasian men reported better physical function but less spirituality, while Hispanic men reported worse sexual function. Multivariate analysis revealed that Hispanic men had significantly worse physical function, bowel function, and bowel bother. African-American men experienced greater anxiety over recurrence. African- American and Hispanic men were more spiritual than Caucasian men. CONCLUSIONS: Greater attention to demographic variations in HRQOL may allow physicians to improve outcomes across ethnicities in low income men with prostate cancer by offering more specialized counseling and providing referral to social support systems. (Ethn Dis. 2005;15:461-468)