High Social Vulnerability Index was associated with lower odds of discordant clinically meaningful change in the sexual domain (OR 0.35; 95% CI 0.16-0.73) two years after prostate cancer treatment.
Cohort (n=8,904)
Yes
Does high social vulnerability index affect clinically meaningful changes in HRQoL-related function and bother in men after prostate cancer treatment?
High social vulnerability is associated with worse baseline health-related quality of life and a greater risk of concurrent declines in both sexual function and bother after prostate cancer treatment.
Effect estimate: OR 0.35 (95% CI 0.16-0.73)
e17025 Background: Clinically meaningful (CM) changes in function and bother have a significant impact on health-related quality of life (HRQoL) after prostate cancer (PCa) treatment. The role of social environment in these changes is unclear. This study aims to examine the relationship between social environment and CM changes in HRQoL-related function and bother after PCa treatment. Methods: Deidentified patient data from CaPSURE registry were geocoded and linked with CDC Social Vulnerability Index (SVI) data, which ranks communities based on vulnerability to public health crises (high SVI: ≥75th percentile nationally). High SVI was defined as ≥75th percentile nationally. HRQoL (0-100 (best)) was assessed using the UCLA Prostate Cancer Index for urinary (UF and UB), sexual (SF and SB), and bowel (BF and BB) function and bother, at baseline and two years post-treatment. CM changes at two years were those > ½ standard deviation from mean baseline scores; changes in function or bother were deemed discordant. Multivariable logistic regressions assessed associations between SVI and discordant CM changes in HRQoL, adjusting for sociodemographics and treatment. Odds ratios (OR) and 95% confidence intervals (CI) were presented, p 3 comorbidities 3–4 (18.3%), and ≥5 (3.9%). Discordant CM changes at two-years post treatment noted in 12.5% for urinary, 17.7% for sexual, and 9.5% for bowel domains. High-SVI patients had lower baseline HRQoL across all domains, for example, UF (89.03 vs 92.63), BF (85.08 vs 88.43), and SF (49.09 vs 53.81). Compared with radical prostatectomy, other treatment modalities were associated with higher odds of urinary and sexual function decline and increased bowel bother. High SVI was linked with lower odds of discordant CM change in sexual domain (OR 0.35, 95% CI 0.16-0.73), but not in urinary or bowel domains. Conclusions: High SVI is associated with worse baseline HRQoL scores and lower odds of discordant, clinically meaningful declines in sexual HRQoL, meaning greater risk of concurrent declines in both sexual function and bother. Linking patients from high SVI communities undergoing PCa treatment with more resources and support may improve HRQoL and survivorship.
Srivastava et al. (Thu,) conducted a cohort in Prostate cancer (n=8,904). High Social Vulnerability Index (SVI) vs. Low SVI was evaluated on Discordant clinically meaningful change in sexual domain (OR 0.35, 95% CI 0.16-0.73). High Social Vulnerability Index was associated with lower odds of discordant clinically meaningful change in the sexual domain (OR 0.35; 95% CI 0.16-0.73) two years after prostate cancer treatment.