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.authorGavin, Anna T.
dc.contributor.authorDonnelly, David
dc.contributor.authorDonnelly, Conan
dc.contributor.authorDrummond, Frances J.
dc.contributor.authorMorgan, Eileen
dc.contributor.authorGormley, Gerard J.
dc.contributor.authorSharp, Linda
dc.contributor.funderProstate Cancer UKen
dc.contributor.funderHealth Research Boarden
dc.contributor.funderPublic Health Agencyen
dc.contributor.funderResearch and Development Office, Northern Ireland
dc.contributor.funderNational Cancer Control Programme, Ireland
dc.date.accessioned2018-02-28T15:42:59Z
dc.date.available2018-02-28T15:42:59Z
dc.date.issued2016-01
dc.date.updated2018-02-28T15:31:15Z
dc.description.abstractAim: 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.sponsorshipHealth Research Board (HRA_HSR/2010/17); Prostate cancer UK (N109–03 and NI-PG13–01)en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleide012952
dc.identifier.citationGavin, 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. DOI: 10.1136/bmjopen-2016-012952en
dc.identifier.doi10.1136/bmjopen-2016-012952
dc.identifier.issn2044-6055
dc.identifier.issued12en
dc.identifier.journaltitleBmj Openen
dc.identifier.urihttps://hdl.handle.net/10468/5567
dc.identifier.volume6en
dc.language.isoenen
dc.publisherBMJ Publishing Group Limiteden
dc.relation.urihttp://bmjopen.bmj.com/content/7/1/e012952corr1
dc.relation.urihttp://bmjopen.bmj.com/content/6/12/e012952
dc.rightsThis 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.urihttp://creativecommons.org/licenses/by-nc/4.0/en
dc.subjectProstate canceren
dc.titleEffect 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 studyen
dc.typeArticle (peer-reviewed)en
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