Health-related quality of life among African American prostate cancer survivors enrolled in a lifestyle intervention program

Abstract Background: Prostate cancer (PC) is the most diagnosed non-skin cancer among men in the United States, with African American (AA) men experiencing the highest incidence of all racial/ethnic groups. Screening and treatment advances for PC have resulted in men living years beyond their diagnosis; however, side effects of PC treatments can impact health-related quality of life (QoL). African American PC survivors (AAPCS) may be at increased risk of experiencing lower QoL. Lifestyle interventions show potential for improving QoL through changes in health behavior and symptom improvement, yet few have focused on AAPCS. This study explores QoL of AAPCS enrolled in Men Moving Forward (MMF), a randomized trial to improve body composition through lifestyle change. Methods: Baseline data from 83 AAPCS enrolled in MMF were used in analysis. Participants completed Patient-Reported Outcomes Measurement Information System (PROMIS) computerized adaptive tests for physical function, anxiety, depression, fatigue, sleep disturbance, social function, and pain intensity. Standardized T scores (U.S. general population mean = 50, SD =10) were generated for all domains except pain intensity (0-10), and summary scores for physical and mental health were generated. A higher score reflects more of a construct being measured. Thus, for symptoms, scores above the mean are worse, while for functioning domains, scores below the mean are worse. Summary scores for physical and mental QoL were also calculated. Questionnaires related to physical activity, self-efficacy, perceived stress, social support, and resilience were also collected. We compare sample means to published norms of U.S. PC survivors, considering a difference of 3 points (1/3 SD) as clinically meaningful. Multiple linear regression analyses were used to examine factors associated with physical and mental health summary scores. Results: AAPCS scores were similar to the U.S. PCS means for depression (45.6 vs 45.4), fatigue (47.9 vs 47.3), sleep disturbance (48.4 vs 48.2), and physical function (50.4 vs 50.2). AAPCS scores were worse than the U.S. PCS means for anxiety (49.4 vs 45.9) and social participation (51.2 vs 55.1). The average mental health summary score for AAPCS was better than the U.S. general population (53.4 vs 50), while the physical health summary score was similar (51.4 vs 50). Perceived stress (p<0.000) was negatively associated with mental health. Comorbidities (p=0.002) were negatively associated with physical health, while physical activity (p=0.034) was positively associated with physical health. Conclusions: Our sample of AAPCS was similar to U.S. PCS except for worse anxiety and social function. We also found that factors that could be impacted by a lifestyle intervention were associated with physical and mental health. Future work will examine additional correlates and explore the impact of the MMF lifestyle intervention on changes in QoL. Citation Format: Iwalola Awoyinka, Kathryn E. Flynn, Anjishnu Banerjee, Alexis Visotcky, Sophia Aboagye, Margaret Tovar, Deepak Kilari, Kathryn A. Bylow, Paula Papanek, Patricia M. Sheean, Melinda R. Stolley. Health-related quality of life among African American prostate cancer survivors enrolled in a lifestyle intervention program [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A034.