Effect of investigation intensity and treatment differences on prostate cancer survivor's physical symptoms, psychological well-being and health-related quality of life: a two country cross-sectional study.

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dc.contributor.author Gavin, Anna T.
dc.contributor.author Donnelly, David
dc.contributor.author Donnelly, Conan
dc.contributor.author Drummond, Frances J.
dc.contributor.author Morgan, Eileen
dc.contributor.author Gormley, Gerard J.
dc.contributor.author Sharp, Linda
dc.date.accessioned 2017-01-04T14:34:02Z
dc.date.available 2017-01-04T14:34:02Z
dc.date.issued 2016-12-19
dc.identifier.citation Gavin, A. T., Donnelly, D., Donnelly, C., Drummond, F. J., Morgan, E., Gormley, G. J. and Sharp, L. (2016) 'Effect of investigation intensity and treatment differences on prostate cancer survivor's physical symptoms, psychological well-being and health-related quality of life: a two country cross-sectional study', BMJ Open, 6(12), e012952 (10 pp). doi: 10.1136/bmjopen-2016-012952 en
dc.identifier.volume 6 en
dc.identifier.issued 12 en
dc.identifier.startpage e012952-1 en
dc.identifier.endpage e012952-10 en
dc.identifier.issn 2044-6055
dc.identifier.uri http://hdl.handle.net/10468/3421
dc.identifier.doi 10.1136/bmjopen-2016-012952
dc.description.abstract Aim: To investigate effects on men's health and well-being of higher prostate cancer (PCa) investigation and treatment levels in similar populations. Participants: PCa survivors in Ireland where the Republic of Ireland (RoI) has a 50% higher PCa incidence than Northern Ireland (NI). Method: A cross-sectional postal questionnaire was sent to PCa survivors 2–18 years post-treatment, seeking information about current physical effects of treatment, health-related quality of life (HRQoL; EORTC QLQ-C30; EQ-5D-5L) and psychological well-being (21 question version of the Depression, Anxiety and Stress Scale, DASS-21). Outcomes in RoI and NI survivors were compared, stratifying into ‘late disease’ (stage III/IV and any Gleason grade (GG) at diagnosis) and ‘early disease’ (stage I/II and GG 2–7). Responses were weighted by age, jurisdiction and time since diagnosis. Between-country differences were investigated using multivariate logistic and linear regression. Results: 3348 men responded (RoI n=2567; NI n=781; reflecting population sizes, response rate 54%). RoI responders were younger; less often had comorbidities (45% vs 38%); were more likely to present asymptomatically (66%; 41%) or with early disease (56%; 35%); and less often currently used androgen deprivation therapy (ADT; 2%; 28%). Current prevalence of incontinence (16%) and impotence (56% early disease, 67% late disease) did not differ between RoI and NI. In early disease, only current bowel problems (RoI 12%; NI 21%) differed significantly in multivariate analysis. In late disease, NI men reported significantly higher levels of gynaecomastia (23% vs 9%) and hot flashes(41% vs 19%), but when ADT users were analysed separately, differences disappeared. For HRQoL, in multivariate analysis, only pain (early disease: RoI 11.1, NI 19.4) and financial difficulties (late disease: RoI 10.4, NI 7.9) differed significantly between countries. There were no significant between-country differences in DASS-21 or index ED-5D-5L score. Conclusions: Treatment side effects were commonly reported and increased PCa detection in RoI has left more men with these side effects. We recommended that men be offered a PSA test only after informed discussion. en
dc.description.sponsorship Northern Ireland Ireland Cancer Registry (funded by the Public Health Agency for Northern Ireland); Prostate cancer UK (N109–03 and NI-PG13–01); Research and Development Office Northern Ireland; Health Research Board (HRA_HSR/2010/17); National Cancer Control Programme, Ireland en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher BMJ Publishing Group en
dc.rights © 2016, The Authurs. Licence BMJ Publishing Group. This article was published in BMJ Open following peer review and can also be viewed on the journal’s website at http://bmjopen.bmj.com. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ en
dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/ en
dc.subject Prostate cancer en
dc.subject PCa detection en
dc.subject PCa en
dc.subject Treatment side effects en
dc.title Effect of investigation intensity and treatment differences on prostate cancer survivor's physical symptoms, psychological well-being and health-related quality of life: a two country cross-sectional study. en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Frances J. Drummond, School of Nursing and Midwifery, University College Cork, Cork, Ireland, T: +353 21 490 3000 E: frances.drummond@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Public Health Agency en
dc.contributor.funder Prostate Cancer UK en
dc.contributor.funder Health Research Board en
dc.contributor.funder Northern Ireland Ireland Cancer Registry en
dc.contributor.funder Research and Development Office Northern Ireland
dc.contributor.funder National Cancer Control Programme, Ireland en
dc.description.status Peer reviewed en
dc.identifier.journaltitle BMJ Open en
dc.internal.copyrightchecked !!CORA!! en
dc.internal.IRISemailaddress frances.drummond@ucc.ie en


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© 2016, The Authurs. Licence BMJ Publishing Group. This article was published in BMJ Open following peer review and can also be viewed on the journal’s website at http://bmjopen.bmj.com. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ Except where otherwise noted, this item's license is described as © 2016, The Authurs. Licence BMJ Publishing Group. This article was published in BMJ Open following peer review and can also be viewed on the journal’s website at http://bmjopen.bmj.com. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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