Abstract
Health disparities in prostate cancer (i.e., increased risk among African American men) require a better understanding of the meaning of race/ethnicity in prostate cancer research, but research thus far on quality of life (QOL) after prostate cancer for men of color and participants from underserved communities is scarce. The goal of this pilot study was to explore issues of race/ethnicity and QOL in a diverse urban population of prostate cancer survivors. The specific aims were: (1) To pilot a method for collecting detailed race/ethnicity data in this population; (2) To examine differences in QOL indicators in this ethnically, linguistically, and educationally underserved and understudied population, 1-2 years post treatment; and (3) To determine whether prostate cancer-specific QOL (i.e., sexual and/or urinary functioning) was associated with global QOL in these populations.
Participants were 54 prostate cancer survivors from one of the lowest income counties in the Northeast, recruited from a large, urban medical center and treated with either radical prostatectomy or prostate brachytherapy. Participants identified their primary race as African American or black (48%); white (26%); Hispanic (22%); and other (4%). Age ranged from 46 to 83 years (mean 65.5 years). All participants were interviewed orally using an IRB-approved protocol. Socio-demographic information was collected using a template adapted from the Family Access to Care Study on HIV (Bruce Rapkin, PI) that included in-depth questions regarding race and ethnicity with the option to check multiple categories and give detailed background information.
Results for Aim 1 from the in-depth race/ethnicity and other demographic questions indicated more ethnic background variability than could be captured by the categories “African American,” “Hispanic,” and “white.” In each group, there was significant within-group diversity; 20% of participants identified with more than one ethnicity (i.e., among African American or black participants, 24% also identified as Caribbean, 11% as African-Black, etc.). Of the Hispanic participants, 15% spoke Spanish as their primary language and chose to be interviewed in Spanish. Nineteen percent of participants did not finish high school, 33% had a high school degree, and 48% had some education beyond high school. In terms of Aim 2, differences in QOL were not found based on demographic variables, indicating that in this pilot sample, ethnicity, education, and language were not associated with QOL. For Aim 3, a linear regression analysis indicated that in terms of sexual functioning, frequency of erections was significantly associated with global QOL, R2 = .06, R1, 52) = 4.63, p = .04. Urinary functioning, however, was not significantly associated with global QOL.
To summarize, this study represents an important first step in examining nuances of race/ethnicity and QOL issues, both prostate cancer-specific and global, in an underserved, ethnically diverse sample of prostate cancer survivors. Research that is conducted multi-lingually can better assess QOL among ethnically, linguistically, and educationally varied populations. Findings suggest that detailed, open-ended assessment of race/ethnic background is fruitful in conducting culturally competent QOL research in diverse communities.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A69.
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