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Abstract：
OBJECTIVE: To examine the association of marital status with prostate cancer outcomes in a racially-diverse cohort.
METHODS: The study population consisted of men (1010 Black; 1070 White) with incident prostate cancer from the baseline North Carolina-Louisiana Prostate Cancer (PCaP) cohort. Marital status at time of diagnosis and screening history were determined by self-report. The binary measure of marital status was defined as married (including living as married) vs. not married (never married, divorced/separated, or widowed). High-aggressive tumors were defined using a composite measure of PSA, Gleason Score, and stage. Definitive treatment was defined as receipt of radical prostatectomy or radiation. Multivariable logistic regression was used to examine the association of marital status with (1) high-aggressive tumors, (2) receipt of definitive treatment, and (3) screening history among Black and White men with prostate cancer.
RESULTS: Black men were less likely to be married than White men (68.1% vs. 83.6%). Not being married (vs. married) was associated with increased odds of high-aggressive tumors in the overall study population (adjusted Odds Ratio (aOR): 1.56; 95% Confidence Interval (CI): 1.20-2.02) and both Black and White men in race-stratified analyses. Unmarried men were less likely to receive definitive treatment in the overall study population (aOR: 0.68; 95% CI: 0.54-0.85). In race-stratified analyses, unmarried Black men were less likely to receive definitive treatment. Both unmarried Black and White men were less likely to have a history of prostate cancer screening than married men.
CONCLUSIONS: Lower rates of marriage among Black men might signal decreased support for treatment decision-making, symptom management, and caregiver support which could potentially contribute to prostate cancer disparities.
METHODS: The study population consisted of men (1010 Black; 1070 White) with incident prostate cancer from the baseline North Carolina-Louisiana Prostate Cancer (PCaP) cohort. Marital status at time of diagnosis and screening history were determined by self-report. The binary measure of marital status was defined as married (including living as married) vs. not married (never married, divorced/separated, or widowed). High-aggressive tumors were defined using a composite measure of PSA, Gleason Score, and stage. Definitive treatment was defined as receipt of radical prostatectomy or radiation. Multivariable logistic regression was used to examine the association of marital status with (1) high-aggressive tumors, (2) receipt of definitive treatment, and (3) screening history among Black and White men with prostate cancer.
RESULTS: Black men were less likely to be married than White men (68.1% vs. 83.6%). Not being married (vs. married) was associated with increased odds of high-aggressive tumors in the overall study population (adjusted Odds Ratio (aOR): 1.56; 95% Confidence Interval (CI): 1.20-2.02) and both Black and White men in race-stratified analyses. Unmarried men were less likely to receive definitive treatment in the overall study population (aOR: 0.68; 95% CI: 0.54-0.85). In race-stratified analyses, unmarried Black men were less likely to receive definitive treatment. Both unmarried Black and White men were less likely to have a history of prostate cancer screening than married men.
CONCLUSIONS: Lower rates of marriage among Black men might signal decreased support for treatment decision-making, symptom management, and caregiver support which could potentially contribute to prostate cancer disparities.
摘要：
目的：在一个种族不同的队列中，研究婚姻状况与前列腺癌预后的关系。
方法：研究人群包括来自基线北卡罗莱纳州-路易斯安那州前列腺癌（PCaP）队列的男性（1010个黑人；1070个白人）。诊断时的婚姻状况和筛查史由自我报告确定。婚姻状况的二元衡量标准定义为已婚(包括已婚生活)与未婚（从未结婚，离婚/分居,或丧偶)。高侵袭性肿瘤是使用PSA的复合测量来定义的，格里森分数,和舞台。明确治疗定义为接受根治性前列腺切除术或放疗。多变量logistic回归用于检查婚姻状况与（1）高侵袭性肿瘤，(2)接受明确治疗，（3）黑人和白人前列腺癌患者的筛查史。
结果：黑人男性结婚的可能性低于白人男性（68.1％vs.83.6%）。未结婚（与已婚）与整个研究人群中高侵袭性肿瘤的几率增加相关（校正赔率比（aOR）：1.56;95％置信区间（CI）：1.20-2.02）以及种族分层分析中的黑人和白人男性。在整个研究人群中，未婚男性接受明确治疗的可能性较小（aOR：0.68；95％CI：0.54-0.85）。在种族分层分析中，未婚的黑人男性不太可能接受明确的治疗。未婚的黑人和白人男性比已婚男性不太可能有前列腺癌筛查史。
结论：黑人男性较低的结婚率可能表明对治疗决策的支持减少，症状管理,和可能导致前列腺癌差异的护理人员支持。
方法：研究人群包括来自基线北卡罗莱纳州-路易斯安那州前列腺癌（PCaP）队列的男性（1010个黑人；1070个白人）。诊断时的婚姻状况和筛查史由自我报告确定。婚姻状况的二元衡量标准定义为已婚(包括已婚生活)与未婚（从未结婚，离婚/分居,或丧偶)。高侵袭性肿瘤是使用PSA的复合测量来定义的，格里森分数,和舞台。明确治疗定义为接受根治性前列腺切除术或放疗。多变量logistic回归用于检查婚姻状况与（1）高侵袭性肿瘤，(2)接受明确治疗，（3）黑人和白人前列腺癌患者的筛查史。
结果：黑人男性结婚的可能性低于白人男性（68.1％vs.83.6%）。未结婚（与已婚）与整个研究人群中高侵袭性肿瘤的几率增加相关（校正赔率比（aOR）：1.56;95％置信区间（CI）：1.20-2.02）以及种族分层分析中的黑人和白人男性。在整个研究人群中，未婚男性接受明确治疗的可能性较小（aOR：0.68；95％CI：0.54-0.85）。在种族分层分析中，未婚的黑人男性不太可能接受明确的治疗。未婚的黑人和白人男性比已婚男性不太可能有前列腺癌筛查史。
结论：黑人男性较低的结婚率可能表明对治疗决策的支持减少，症状管理,和可能导致前列腺癌差异的护理人员支持。
