Quality of life and health status among prostate cancer survivors and noncancer population controls

Objective: 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.

Methods: 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.

Results: 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).

Conclusion: 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.