MedWire News: Long-term prostate cancer survivors have worse mental health if they have a low rather than high socioeconomic status (SES), show Dutch study results.
By contrast, SES has no real impact on overall physical wellbeing, and has less impact on mental or physical health overall than comorbidities, report Mieke Aarts (Comprehensive Cancer Center South, Eindhoven, The Netherlands) and colleagues.
The team assessed whether the presence of socioeconomic inequalities was associated with HRQoL and health care use among 584 long-term (5-10 years) prostate cancer survivors who reported their mental and physical state via a questionnaire.
Patients' SES was calculated according to their income and the value of their home, and HRQoL was measured using the Short Form-36 questionnaire, which incorporated the Physical Component Summary (PCS) and Mental Component Summary (MCS) where higher scores (up to 100) indicate better functioning.
After adjustment for factors including tumor stage, primary therapy, time since diagnosis, and age, socioeconomic disparity existed in most of the MCS scores but none of the PCS scores.
Specifically, MCS scores were worse for low SES than high SES patients, ranging from approximate averages of 49 to 55, while PCS scores only ranged from approximately 43 to 46, respectively. Furthermore, the difference between low and high MCS scores was statistically significant.
Aarts et al note that patients of low (deciles 1-3) SES had more comorbidities both at diagnosis and at the time they returned the questionnaire compared with patients with intermediate (deciles 4-7) and high (deciles 8-10) SES.
In fact, having a comorbidity predicted worse HRQoL more strongly than SES on multivariate analysis. Comorbidities accounted for 9-12% of PCS scores and 3-8% of MCS scores, whereas SES contributed to just 1-2% and 2-3%, respectively.
Finally, SES was neither associated with the frequency of patient contact with a physician, nor with the number of visits patients made to medical centers.
"Doctors would be wise to anticipate comorbid conditions among prostate cancer survivors, especially among those with low SES, to diminish SES disparities in mental HRQoL and to maximize long-term outcomes," conclude the researchers in the journal Urology.
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