Identification and prediction of health‐related quality of life trajectories after a prostate cancer diagnosis

Abstract

The aim of our study was to identify physical and mental health-related quality of life (HRQoL) trajectories after a prostate cancer diagnosis and systematically characterize trajectories by behaviours and prognostic factors. Prostate cancer survivors (n = 817) diagnosed between 1997 and 2000 were recruited between 2000 and 2002 into a prospective repeated measurements study. Behavioural/prognostic data were collected through in-person interviews and questionnaires. HRQoL was collected at three post-diagnosis time-points, approximately 2 years apart using the Short Form (SF)-36 validated questionnaire. To identify physical and mental HRQoL trajectories, group-based trajectory modelling was undertaken. Differences between groups were evaluated by assessing influential dropouts (mortality/poor health), behavioural/prognostic factors at diagnosis or during the follow-up. Three trajectories of physical HRQoL were identified including: average-maintaining HRQoL (32.2%), low-declining HRQoL (40.5%) and very low-maintaining HRQoL (27.3%). In addition, three trajectories for mental HRQoL were identified: average-increasing HRQoL (66.5%), above average-declining HRQoL (19.7%) and low-increasing HRQoL (13.8%). In both physical and mental HRQoL, dropout from mortality/poor health differed between trajectories, thus confirming HRQoL and mortality were related. Furthermore, increased Charlson comorbidity index score was consistently associated with physical and mental HRQoL group membership relative to average maintaining groups, while behaviours such as time-varying physical activity was associated with physical HRQoL trajectories but not mental HRQoL trajectories. It was possible to define three trajectories of physical and mental HRQoL after prostate cancer. These data provide insights regarding means for identifying subgroups of prostate cancer survivors with lower or declining HRQoL after diagnosis whom could be targeted for interventions aimed at improving HRQoL.

Trajectories of health-related quality of life among people with a physical disability and/or chronic disease during and after rehabilitation: a longitudinal cohort study

“…However, the direction of the association indicates that people who were more physically active before discharge from rehabilitation were more likely to follow the high HR-QoL trajectory compared to people in the moderate HR-QoL trajectory. This might imply that more physical activity is associated with higher HR-QoL, which supports previous literature [7,9,50,51].…”

Coping and adjustment in men with prostate cancer: a systematic review of qualitative studies

“…Health outcomes for PCa are influenced by various physical and psychological factors, such as symptoms experienced [ 10 ], treatment received [ 11 , 12 ], and extent of masculine identity threat [ 13 ]. There is also support for different mental health-related quality of life trajectories [ 14 ]. Combined with methodological differences, these factors may have contributed to variations in reported outcomes.…”

Trajectory analysis in obesity epidemiology: A promising life course approach

“…For example, a study characterized postdiagnosis trajectories of physical and mental Health-Related Quality of Life (HRQoL) in prostate cancer survivors and identified a group of patients with lower and declining HRQoL for potential interventions. [24] Another study characterized trajectories of physical activity and physical function in cancer survivors enrolled in a randomized trial of home-based lifestyle counseling and identified characteristics of survivors who benefited from the assigned interventions. [25] Cautions and challenges…”