Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC.
Department of Biostatistics, Bioinformatics and Biomathematics, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.
JCO Oncol Pract. 2024 Jul;20(7):921-931. doi: 10.1200/OP.24.00076. Epub 2024 Mar 11.
Our purpose was to describe the prevalence and predictors of symptom and function clusters related to physical, emotional, and social components of general health-related quality of life (HRQOL) in a population-based sample of prostate cancer (PCa) survivors.
Participants (N = 1,162) completed a baseline survey at a median of 9 months after diagnosis to ascertain the co-occurrence of eight symptom and functional domains that are common across all cancers and not treatment-specific. We used latent profile analysis (LPA) to identify subgroup profiles of survivors with low, moderate, or high HRQOL levels. Multinomial logistic regression models were used to identify clinical and sociodemographic factors associated with survivors' membership in the low versus moderate or high HRQOL profile.
The LPA identified 16% of survivors who were categorized in the low HRQOL profile at baseline, indicative of the highest symptom burden and lowest functioning. Factors related to survivors' membership in the low versus higher HRQOL profile groups included less than age 65 years at diagnosis, identifying as non-Hispanic Black race, not working, being a former versus never smoker, systemic therapy, less companionship, more comorbidities, lower health care financial well-being, or less spirituality. Several factors remained associated with remaining in the low versus higher HRQOL profiles on the follow-up survey (n = 699), including younger age, Black race, comorbidity, and lower financial and spiritual well-being.
About one of six PCa survivors experienced elevated physical and psychosocial symptoms that were independent of local curative therapy, but with younger age, race, comorbidity, and lower financial and spiritual well-being as stable risk factors for poor HRQOL over time.
本研究旨在描述与一般健康相关生活质量(HRQOL)的身体、情感和社会成分相关的症状和功能群在前列腺癌(PCa)幸存者人群中的流行率和预测因素。
参与者(N=1162)在诊断后中位数为 9 个月时完成基线调查,以确定跨越所有癌症且非治疗特异性的 8 个症状和功能域的共同发生。我们使用潜在剖面分析(LPA)确定具有低、中或高 HRQOL 水平的幸存者亚组特征。使用多项逻辑回归模型确定与幸存者低与中或高 HRQOL 特征组相关的临床和社会人口统计学因素。
LPA 确定了 16%的基线时处于低 HRQOL 特征的幸存者,表明症状负担最高,功能最低。与幸存者低与高 HRQOL 特征组相关的因素包括诊断时年龄小于 65 岁、非西班牙裔黑人种族、不工作、以前吸烟而非从不吸烟、系统治疗、伴侣较少、更多共病、较低的医疗保健财务状况或较少的精神信仰。在随访调查(n=699)中,一些因素仍与低与高 HRQOL 特征组保持相关,包括年龄较小、黑人种族、共病以及财务和精神健康状况较差。
约六分之一的 PCa 幸存者经历了与局部治愈性治疗无关的身体和心理社会症状升高,但年龄较小、种族、共病以及财务和精神健康状况较差是随着时间推移 HRQOL 持续较差的稳定风险因素。