Racial/Ethnic Differences in Health-Related Quality of Life Among Gay and Bisexual Prostate Cancer Survivors

Alex J Bates; B R Simon Rosser; Elizabeth J Polter; Christopher W Wheldon; Kristine M C Talley; Ryan Haggart; Morgan Wright; Darryl Mitteldorf; William West; Michael W Ross; Badrinath R Konety; Nidhi Kohli

doi:10.3389/fonc.2022.833197

Racial/Ethnic Differences in Health-Related Quality of Life Among Gay and Bisexual Prostate Cancer Survivors

Front Oncol. 2022 Apr 13:12:833197. doi: 10.3389/fonc.2022.833197. eCollection 2022.

Authors

Affiliations

¹ Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States.
² Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, United States.
³ Adult and Geriatric Health, University of Minnesota School of Nursing, Minneapolis, MN, United States.
⁴ Department of Urology, University of Minnesota, Minneapolis, MN, United States.
⁵ Malecare Cancer Support, New York, NY, United States.
⁶ Department of Writing Studies, University of Minnesota, Minneapolis, MN, United States.
⁷ Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, United States.
⁸ Allina Health Cancer Institute, Minneapolis, MN, United States.
⁹ Department of Educational Psychology, University of Minnesota, Minneapolis, MN, United States.

Abstract

Introduction: Prostate cancer treatment has established effects on the health-related quality of life (HRQOL) of patients. While racial/ethnic differences in HRQOL have been explored in heterosexual patients, this is the first study to examine racial/ethnic differences in a cohort of sexual minority prostate cancer survivors.

Methods: We used data from the Restore-1 study, an online cross-sectional survey of sexual and gender minority (SGM) prostate cancer survivors in North America, to explore the association between race/ethnicity and HRQOL. General mental and physical HRQOL was assessed using the Short-Form Health Survey version 2 (SF-12). The frequency and distress of prostate cancer specific symptoms was assessed using the Expanded Prostate Cancer Composite (EPIC) scale. Multivariable linear regression was used to estimate mean differences in HRQOL between sexual minority men of color and their white, non-Hispanic counterparts after adjustment for pertinent demographic and medical characteristics.

Results: Among 190 participants, 23 (12%) self-identified as non-white and/or Hispanic. In unadjusted analysis, sexual minority men of color compared to their white counterparts reported worse HRQOL scores in the EPIC hormonal summary (73.8 vs. 81.8) and hormonal function (70.9 vs 80.5) domains. Clinically important differences between men of color and their white counterparts were seen in the EPIC bowel function (mean difference (MD): -4.5, 95% CI: -9.9, 0.8), hormonal summary (MD: -8.0, 95% CI: -15.6, -0.4), hormonal function (MD: -9.6, 95% CI: -17.6, -1.6), and hormonal bother (MD: -6.7, 95% CI: -14.4, 1.1) domains. After adjustment for covariates, clinically important differences persisted between men of color and white, non-Hispanic men on the hormonal summary (74.4 vs. 81.7), hormonal function (71.3 vs. 80.3), and hormonal bother (77.0 vs. 82.7) domains.

Conclusions: This exploratory study provides the first evidence that sexual minority men of color may have worse HRQOL outcomes compared to white, non-Hispanic sexual minority men following prostate cancer treatment.

Keywords: cancer; ethnic groups/epidemiology; oncology; prostatic neoplasms; quality of life; sexual and gender minorities (SGMs).