MP86-14 PROSTATE SPECIFIC ANTIGEN AND HEALTH-RELATED QUALITY-OF-LIFE OUTCOMES IN UNINSURED MEN WITH PROSTATE CANCER

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life and Shared Decision Making V1 Apr 2017MP86-14 PROSTATE SPECIFIC ANTIGEN AND HEALTH-RELATED QUALITY-OF-LIFE OUTCOMES IN UNINSURED MEN WITH PROSTATE CANCER Avi Baskin, Joseph Shirk, Lorna Kwan, and Karim Chamie Avi BaskinAvi Baskin More articles by this author , Joseph ShirkJoseph Shirk More articles by this author , Lorna KwanLorna Kwan More articles by this author , and Karim ChamieKarim Chamie More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2697AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate Specific Antigen (PSA) continues to be a useful marker of risk strata and disease progression for patients with prostate cancer. While there have been multiple investigations into the relationship between PSA and mortality, there is a dearth in the literature describing the association between PSA and health-related quality-of-life (HRQOL) outcomes. In this study, we hypothesize that PSA is inversely related with HRQOL in patients with prostate cancer. METHODS Our cohort consisted of a prospective analysis of men from a state-funded program that provides free prostate cancer care to underinsured and uninsured low-income California residents with prostate cancer. Highest pre-treatment PSA was our primary exposure variable of interest. We created 4 strata: <10, 10-19.9, 20-49.9 and ≥50 PSA. The primary outcome variables were HRQOL at program enrollment using the RAND SF-12 to measure physical and mental health, and the UCLA Prostate Cancer Index Short Form to measure urinary, sexual and bowel habits in two domains: bother and function. Controlling for demographic and clinical variables, we conducted separate multivariable linear regression analysis for each quality of life domain. RESULTS 627 men were eligible for the study. Age, ethnicity, primary language, education and Charlson comorbidity did not differ across PSA strata. Compared to the referent group PSA <10, those with PSA ≥50 were more likely to receive androgen deprivation therapy as their primary form of treatment (p <0.01). Patients with PSAs 10-19.9 were more likely to have sexual bother (β=11.1, p<0.03) compared to the referent group. (See Table) There were no other differences in other HRQOL domains across PSA strata. CONCLUSIONS In this population, we found no statistically significant difference in HRQOL outcomes by PSA level. The finding that patients with very elevated PSA levels having outcomes that were no worse than patients with less aggressive disease is important clinically because most quality of life detriments tend to be from treatment of localized disease. Further, these findings will inform physicians on patient symptomatology despite PSA level. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1161-e1162 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Avi Baskin More articles by this author Joseph Shirk More articles by this author Lorna Kwan More articles by this author Karim Chamie More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...