Health Disparities of Sexual Minority Patients Following Prostate Cancer Treatment: Results From the Restore-2 Study.
Health Disparities of Sexual Minority Patients Following Prostate Cancer Treatment: Results From the Restore-2 Study.
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DOI：
10.3389/fonc.2022.812117
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发表时间：
2022
影响因子：
4.7
通讯作者：
Kohli N
中科院分区：
文献类型：
--
作者：
Rosser BRS;Polter EJ;Talley KMC;Wheldon CW;Haggart R;Wright M;West W;Mitteldorf D;Ross MW;Konety BR;Kohli N
美国国立卫生研究院已将性少数和性别少数人群确定为健康差异人群，但对这些人群的癌症结局知之甚少。本研究的目的是确定性少数前列腺癌患者报告结果的差异，检查组内差异，并测试确定差异的其他解释。2019年，我们招募了401名同性恋和双性恋前列腺癌患者参与Restore-2研究，这是一项为性少数男性量身定制的康复计划的随机对照试验。与标准的（异性恋）EPIC样本相比，参与者的尿、肠和激素功能明显较差，性功能较好，而烦恼评分没有差异。他们的抑郁和整体心理健康状况也更差，身体、社会/家庭、功能、前列腺特异性和整体健康生活质量结果也更差。通过测量，没有观察到年龄、同性恋与双性恋取向、种族/民族和关系状况的差异。接受激素治疗的患者的性功能和激素功能比只接受放疗或手术的患者差。治疗时间较长的患者尿功能较好。当参与者在癌症分期和治疗后的时间上与标准样本相匹配时，差异仍然存在。这是迄今为止对性少数前列腺癌患者进行的最大规模的研究，证实了前列腺癌生活质量结果的健康差异。研究结果似乎可靠而有力。为了改善前列腺癌的临床护理，解决性少数前列腺癌患者的健康差异将是重要的。
The NIH has identified sexual and gender minority persons as a health disparity population but little is known about cancer outcomes in these populations. The purpose of this study was to identify disparities in sexual minority prostate cancer patient-reported outcomes, to examine within group differences, and to test for alternative explanations for identified differences. In 2019, we recruited 401 gay and bisexual prostate cancer patients into the Restore-2 study, a randomized controlled trial of rehabilitation program tailored for sexual minority men. Compared to the normative (heterosexual) EPIC sample, participants had significantly worse urinary, bowel and hormonal function, better sexual function, and no difference on bother scores. They also had worse depression and overall mental health, and worse physical, social/family, functional, prostate specific and overall well-being quality of life outcomes. Across measures, no differences by age, gay versus bisexual orientation, race/ethnicity, and relationship status were observed. Those who had hormonal treatment had worse sexual and hormonal function than those who had radiation or surgery only. Those with a longer time since treatment had better urinary function. Differences remained when participants were matched to normative samples on cancer stage and time since treatment. This, the largest study of sexual minority prostate cancer patients to date, confirms health disparities in prostate cancer quality of life outcomes. Findings appear reliable and robust. To improve the clinical care of prostate cancer, it will be important to address the health disparities experienced by sexual minority prostate cancer patients.
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