Abstract A018: Examination of longitudinal changes in work ability by race and income in men undergoing curative treatment for prostate cancer (PCW-1802)

Abstract Purpose of Study: Approximately 40% of men diagnosed with prostate cancer (PC) are younger than age 65. Treatment can result in challenges at the workplace, and may exacerbate health disparities. This study was designed to examine changes in work ability by race and income across PC survivors. Methods: Employed men who were expected to undergo primary treatment for PC and who anticipated working six months post-treatment were recruited through the Wake Forest NCI Community Oncology Research Program (NCORP) Research Base (NCT03963739) between 2019 and 2023. As designed, study participants were stratified by lower and higher income (</≥ 300% U.S. poverty line) and by African American (AA) and white race. Participants were administered questionnaires prior to treatment initiation (prostatectomy or radiation therapy) and six months post-treatment completion regarding work ability, as recorded using the Work Ability Index total score (WAI) and the Work Limitations Questionnaire Productivity Loss Index (WLQ-PLI). Demographic and work-related information were participant-reported; cancer treatment information was extracted from medical records. Changes in work outcomes from baseline to 6 months were assessed using generalized linear models, with higher changes representing better work ability. For each outcome, full models considered race, income, and the interaction of race by income, adjusted for baseline work outcome, age, marital status, education, main job category, and FMLA status at job and treatment variables radiation, prostatectomy and/or additional androgen deprivation therapy. Results: 255 were enrolled; 68 (27%) AA higher income, 57 (22%) AA lower income, 95 (37%) white higher income, and 35 (14%) white lower income. 190 (75%) completed 6-month assessments; differential dropout was significant (p=0.0067) with 6-month retention rates of higher AA 64.7%, higher white 83.16%, lower AA 80.7%, and lower white 60%. WAI changes were different by race (AA = 0.4573 versus white = -0.01410, p=0.0165) but not income. Additionally, worsening WAI at 6 months was also associated with higher WAI at baseline (-0.49, p<0.001) and more baseline comorbidities (p=0.007). For WLQ-PLI, there were no significant changes between baseline and 6 months by race or income; however, worsening WLQ changes at 6 months were associated with higher baseline WLQ-PLI values (-0.07, p=0.03), older age (-0.51, p<0.001), and more baseline comorbidities (p=0.03). Conclusion: Race and income have a limited effect on changes in work ability between the period shortly before treatment and six months post-treatment. However, those who have better work ability prior to treatment initiation are at increased risk of having decreased work ability 6 months after treatment. Research that addresses how specific working conditions experienced by prostate cancer survivors from different racial and income strata influence post-treatment work ability is warranted. Funding: This work was supported by a grant from the NCI, UG1CA189824 (Wake Forest NCORP RB) and DOD (W81XWH-16-1-078). Citation Format: Joanne C. Sandberg, Emily V. Dressler, Louis S. Krane, Karen M. Winkfield, Lingyi Lu, Andy Mayfield, Jeremy M. Kilburn, J. Daniel. Pennington, Deimante M. Tamkus, Glenn J. Lesser. Examination of longitudinal changes in work ability by race and income in men undergoing curative treatment for prostate cancer (PCW-1802) [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A018.