Racial differences in quality of life following prostate cancer diagnosis.

CS19-03

Each year thousands of men are diagnosed with prostate cancer. Although a substantial number of studies have shown that African American men experience excess rates of morbidity and mortality from prostate cancer compared to men from other ethnic and racial groups, much less is known about racial differences in quality of life (QOL) among men affected with disease. QOL is a multi-dimensional construct that includes an individual's perceptions of their psychological well-being and physical impairment. The purpose of this study was to examine racial differences in emotional and physical QOL among African American and Caucasian men who were newly diagnosed with prostate cancer. Participants were 129 African American (n=47) and Caucasian (n=82) men who were enrolled in a prospective longitudinal study of QOL within two to three months following their prostate cancer diagnosis. Men completed the emotional (EWB) and physical (PWB) well-being subscales of the Functional Assessment of Cancer Therapy (FACT) during a structured telephone interview. African American men reported significantly greater levels of EWB (Mean=21.2) compared to Caucasian (Mean=19.9) (Kruskal-Wallis Chi Square=6.89, p<0.001) in bivariate analysis. Similar differences were found in terms of PWB (African American Mean=24.5 versus Caucasian Mean=23.0, Kruskal-Wallis Chi Square=5.10, p<0.05). In addition, men with greater perceptions of stress reported lower EWB (r=-0.68, p=0.001) and PWB (r=-0.52, p=0.001). In multivariate regression models that controlled for clinical factors, treatment status, and medical setting, race and perceived stress had significant effects on EWB. African American men reported significantly greater EWB compared to Caucasian men (Coefficient=1.59, p=0.04), whereas men with greater perceived stress reported lower EWB (Coefficient=-0.29, p=0.001). Greater perceived stress also had a significant effect on PWB (Coefficient=-0.24, p=0.001). These findings demonstrate that African American men may have greater emotional well-being shortly after being diagnosed with prostate cancer; however, QOL may be adversely affected by greater life stress. Thus, in addition to race, contextual factors are likely to be important to some aspects of QOL among men newly diagnosed with prostate cancer.