美国转移性疾病和非转移性疾病的前列腺癌幸存者以及无癌症病史男性的健康相关生活质量。
Health-related quality of life among prostate cancer survivors with metastatic disease and non-metastatic disease and men without a cancer history in the USA.
作者信息
Zheng Zhiyuan, Shi Kewei Sylvia, Kamal Arif, Howard David H, Horný Michal, Richards Thomas B, Ekwueme Donatus U, Yabroff K Robin
机构信息
American Cancer Society, Atlanta, GA, USA.
Emory University Rollins School of Public Health, Atlanta, GA, USA.
出版信息
J Cancer Surviv. 2025 Jun;19(3):871-883. doi: 10.1007/s11764-023-01509-8. Epub 2023 Dec 16.
BACKGROUND
Few studies have comprehensively compared health-related quality of life (HRQoL) between metastatic prostate cancer survivors, survivors with non-metastatic disease, and men without a cancer history.
METHODS
We used the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey (SEER-MHOS) data linkage to identify men aged ≥ 65 years enrolled in Medicare Advantage (MA) plans. Prostate cancer survivors were diagnosed between 1988 and 2017 and completed MHOS surveys between 1998 and 2019. We analyzed data from 752 metastatic prostate cancer survivors (1040 survey records), 19,583 localized or regional prostate cancer survivors (non-metastatic; 30,121 survey records), and 784,305 men aged ≥ 65 years without a cancer history in the same SEER regions (1.15 million survey records). We used clustered linear regressions to compare HRQoL measures at the person-level using the Veterans RAND 12 Item Health Survey (VR-12) T-scores for general health and physical and mental component summaries.
RESULTS
Compared to men without a cancer history, prostate cancer survivors were older, more likely to be married, and had higher socioeconomic status. Compared to men without a cancer history, metastatic prostate cancer survivors reported lower general health (T-score differences [95% confidence interval]: - 6.26, [- 7.14, - 5.38], p < .001), physical health (- 4.33, [- 5.18, - 3.48], p < .001), and mental health (- 2.64, [- 3.40, - 1.88], p < .001) component summaries. Results were similar for other VR-12 T-scores. In contrast, non-metastatic prostate cancer survivors reported similar VR-12 T-scores as men without a cancer history. Further analyses comparing metastatic and non-metastatic prostate cancer survivors support these findings.
CONCLUSION
Interventions to improve health-related quality of life for men diagnosed with metastatic prostate cancer merit additional investigation.
IMPLICATIONS FOR CANCER SURVIVORS
Interventions to improve health-related quality of life for metastatic prostate cancer survivors merit additional investigation.
背景
很少有研究全面比较转移性前列腺癌幸存者、非转移性疾病幸存者以及无癌症病史男性之间的健康相关生活质量（HRQoL）。
方法
我们利用监测、流行病学和最终结果-医疗保险健康结果调查（SEER-MHOS）数据链接，确定参加医疗保险优势（MA）计划的65岁及以上男性。前列腺癌幸存者于1988年至2017年被诊断，并于1998年至2019年完成了MHOS调查。我们分析了来自752名转移性前列腺癌幸存者（1040份调查记录）、19583名局限性或区域性前列腺癌幸存者（非转移性；30121份调查记录）以及在相同SEER地区的784305名无癌症病史的65岁及以上男性（115万份调查记录）的数据。我们使用聚类线性回归，以退伍军人兰德12项健康调查（VR-12）的总体健康、身体和精神成分总结的T分数，在个体层面比较HRQoL指标。
结果
与无癌症病史的男性相比，前列腺癌幸存者年龄更大，结婚可能性更高，社会经济地位也更高。与无癌症病史的男性相比，转移性前列腺癌幸存者报告的总体健康（T分数差异[95%置信区间]：-6.26，[-7.14，-5.38]，p<.001）、身体健康（-4.33，[-5.18，-3.48]，p<.001）和心理健康（-2.64，[-3.40，-1.88]，p<.001）成分总结更低。其他VR-12 T分数的结果相似。相比之下，非转移性前列腺癌幸存者报告的VR-12 T分数与无癌症病史的男性相似。比较转移性和非转移性前列腺癌幸存者的进一步分析支持了这些发现。
结论
改善转移性前列腺癌男性患者健康相关生活质量的干预措施值得进一步研究。
对癌症幸存者的启示
改善转移性前列腺癌幸存者健康相关生活质量的干预措施值得进一步研究。
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