Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK; Leeds Institute of Data Analytics, University of Leeds, Leeds, UK.
Leeds Institute of Data Analytics, University of Leeds, Leeds, UK; Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
Cancer Epidemiol. 2020 Dec;69:101830. doi: 10.1016/j.canep.2020.101830. Epub 2020 Sep 28.
In the UK, inequalities exist in prostate cancer incidence, survival and treatment by area deprivation and rurality. This work aimed to identify variation in patient-reported outcomes of men with prostate cancer by area type.
A population-based survey of men 18-42 months after prostate cancer diagnosis (N = 35608) measured self-assessed health (SAH) using the EQ-5D and five functional domains using the Expanded Prostate Cancer Index Composite (EPIC-26).
Mean SAH was higher for men in least deprived areas compared to most deprived (difference 6.3 (95 %CI 5.6-7.2)). SAH scores were lower for men in most urban areas compared to most rural (difference 2.4 (95 %CI 1.8-3.0)). Equivalent estimates in the general population reported a 13 point difference by deprivation and a 4 point difference by rurality. For each EPIC-26 domain, functional outcomes were better for men in the least deprived areas, with clinically meaningful differences observed for urinary incontinence and hormonal function. There were no clinically meaningful differences in EPIC-26 outcomes by rurality with less than a three point difference in scores for each domain between urban and rural areas.
In men 18-42 months post diagnosis of prostate cancer in the UK, impacts of area deprivation and rurality on self-assessed health related quality of life were not greater than would be expected in the general population. However, clinically meaningful differences were identified for some prostate functional outcomes (urinary and hormonal function) by deprivation. No impact by rurality of residence was identified.
在英国，前列腺癌的发病率、生存率和治疗方式存在地区贫困和农村差异。本研究旨在确定不同地区类型的前列腺癌患者报告的结局的变化。
对前列腺癌诊断后 18-42 个月的男性进行基于人群的调查（N=35608），使用 EQ-5D 评估自我评估健康（SAH），使用扩展前列腺癌指数综合量表（EPIC-26）评估五个功能领域。
与最贫困地区的男性相比，最贫困地区的男性 SAH 更高（差异为 6.3（95%CI 5.6-7.2））。与最农村地区的男性相比，大多数城市地区的男性 SAH 更低（差异为 2.4（95%CI 1.8-3.0））。在一般人群中，同样的估计值显示，按贫困程度差异为 13 分，按农村程度差异为 4 分。对于每个 EPIC-26 领域，最贫困地区的男性功能结局更好，尿失禁和激素功能方面存在有临床意义的差异。农村地区的 EPIC-26 结局没有有临床意义的差异，每个领域的评分差异小于 3 分。
在英国前列腺癌诊断后 18-42 个月的男性中，地区贫困和农村对自我评估健康相关生活质量的影响并不大于一般人群。然而，一些前列腺功能结局（尿和激素功能）的差异存在有临床意义。居住地的农村差异没有影响。
