QOL and outcomes research in prostate cancer patients with low socioeconomic status

The VA Cancer of the Prostate Outcomes Study (VA CaPOS) is collecting quali ty-of-life (QOL) information from prostate cancer patients, spouses, and ph ysicians at six VA medical centers. Currently, 601 men with prostate cancer are included in the study, most of whom ave of low socioeconomic status an d over half of whom are African-American. Quality-of-life responses were mo st favorable for newly diagnosed patients, intermediate for those with stab le metastatic disease, and poorest for those with progressive metastatic di sease. Patients could not provide reliable estimates of their own preferenc es for future QOL states but responded reliably to questions phrased as a c omparison of the preferences of two hypothetical patients. High out-of-pock et costs for hormonal therapies, lack of health insurance, and a belief tha t the non-VA system offered poorer services were the most common reasons fo r patient transferral to the VA system. Satisfaction with medical care was generally high. While African-American patients were more likely to have ad vanced prostate cancer at diagnosis, after adjustment for differences in he alth literacy, race was no longer a significant predictor of advanced disea se, The VA CaPOS provides useful information on health statics and patient satisfaction of VA prostate cancer patients. Long-term evaluations are need ed to detect clinically meaningful QOL information as the disease progresse s.