Quality of Life and Health Status Among Prostate Cancer Survivors and Noncancer Population Controls

Abstract

To examine whether quality of life (QOL), health status, and the relationships between them varied by having a prostate cancer history. This study helps to inform the interface between aging-related health decline and the survival state among older men with prostate cancer, which is an important yet understudied public health issue. Hierarchical linear models were used to analyze the cross-sectional data from the nationally representative population-based Medical Expenditure Panel Survey. Using propensity score matching, survivors (respondents with prostate cancer history) and controls (respondents without a history of any cancer) (N= 193 pairs) were matched based on 7 sociodemographic and health-related factors. QOL was measured using the mental and physical component scores of the SF-12 (SF-36.org). Health status included comorbidities, activities of daily living (ADL), instrumental ADL, and depressed mood. In bivariate analyses, survivors reported worse physical (42.72 vs 45.45 respectively; P= .0040) and mental QOL (51.59 vs 53.73 respectively; P= .0295) and more comorbidities (3.25 vs 2.78 respectively; P= .0139) than controls. In multivariate analyses, for both survivors and controls, better physical QOL was associated with fewer comorbidities (P<.0001), no need help with ADL (P= .0011) and IADL (P= .0162), and less depressed mood (P<.0001); better mental QOL was associated with no need help with IADL (P= .0005) and less depressed mood (P<.0001). QOL of older men is affected by physical, functional, and psychological factors rather than prostate cancer history. Clinicians need to attend to aging-related health issues when providing care for prostate cancer survivors to improve QOL.