Rosser B R Simon, Polter Elizabeth J, Talley Kristine M C, Wheldon Christopher W, Haggart Ryan, Wright Morgan, West William, Mitteldorf Darryl, Ross Michael W, Konety Badrinath R, Kohli Nidhi
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States.
Adult and Gerontological Health Cooperative, University of Minnesota School of Nursing, Minneapolis, MN, United States.
Front Oncol. 2022 Feb 4;12:812117. doi: 10.3389/fonc.2022.812117. eCollection 2022.
The NIH has identified sexual and gender minority persons as a health disparity population but little is known about cancer outcomes in these populations. The purpose of this study was to identify disparities in sexual minority prostate cancer patient-reported outcomes, to examine within group differences, and to test for alternative explanations for identified differences.
In 2019, we recruited 401 gay and bisexual prostate cancer patients into the study, a randomized controlled trial of rehabilitation program tailored for sexual minority men.
Compared to the normative (heterosexual) EPIC sample, participants had significantly worse urinary, bowel and hormonal function, better sexual function, and no difference on bother scores. They also had worse depression and overall mental health, and worse physical, social/family, functional, prostate specific and overall well-being quality of life outcomes. Across measures, no differences by age, gay versus bisexual orientation, race/ethnicity, and relationship status were observed. Those who had hormonal treatment had worse sexual and hormonal function than those who had radiation or surgery only. Those with a longer time since treatment had better urinary function. Differences remained when participants were matched to normative samples on cancer stage and time since treatment.
This, the largest study of sexual minority prostate cancer patients to date, confirms health disparities in prostate cancer quality of life outcomes. Findings appear reliable and robust. To improve the clinical care of prostate cancer, it will be important to address the health disparities experienced by sexual minority prostate cancer patients.
美国国立卫生研究院已将性取向和性别少数群体确定为健康差异人群，但对这些人群的癌症结局知之甚少。本研究的目的是确定性少数群体前列腺癌患者报告结局中的差异，研究组内差异，并检验已确定差异的其他解释。
2019年，我们招募了401名男同性恋和双性恋前列腺癌患者参与一项针对性少数群体男性量身定制的康复计划的随机对照试验。
与正常（异性恋）的EPIC样本相比，参与者的泌尿、肠道和激素功能明显更差，性功能更好，困扰评分无差异。他们的抑郁和整体心理健康状况也更差，身体、社会/家庭、功能、前列腺特异性和整体生活质量结局也更差。在各项指标中，未观察到年龄、男同性恋与双性恋取向、种族/族裔和恋爱状况的差异。接受激素治疗的患者比仅接受放疗或手术的患者性功能和激素功能更差。治疗后时间较长的患者泌尿功能更好。当根据癌症分期和治疗后时间将参与者与正常样本进行匹配时，差异仍然存在。
这是迄今为止对性少数群体前列腺癌患者规模最大的研究，证实了前列腺癌生活质量结局中的健康差异。研究结果似乎可靠且有力。为改善前列腺癌的临床护理，解决性少数群体前列腺癌患者所经历的健康差异至关重要。
