Donnelly, DW, Gavin, A, Downing, A orcid.org/0000-0002-0335-7801 et al. (20 more authors) (2019) Regional variations in quality of survival among men with prostate cancer across the United Kingdom. European Urology, 76 (2). pp. 228-237. ISSN 0302-2838
Abstract
Background: Prostate cancer incidence, treatment, and survival rates vary throughout the UK, but little is known about regional differences in quality of survival.
Objective: To investigate variations in patient-reported outcomes between UK countries and English Cancer Alliances.
Design, setting, and participants: A cross-sectional postal survey of prostate cancer survivors diagnosed 18–42 mo previously.
Outcome measurements and statistical analysis: Urinary, bowel, and sexual problems and vitality were patient reported using the Expanded Prostate Cancer Index Composite (EPIC-26) questionnaire. General health was also self-assessed. Regional variations were identified using multivariable log-linear regression.
Results and limitations: A total of 35 823 men responded, 60.8% of those invited. Self-assessed health was significantly lower than the UK average in Wales and Scotland. Respondents reported more urinary incontinence in Scotland, more urinary irritation/obstruction in Scotland and Northern Ireland (NI), poorer bowel function in Scotland and NI, worse sexual function in Scotland, and reduced vitality/hormonal function in Scotland, Wales, and NI. Self-assessed health was poorer than the English average in South Yorkshire and North-East and Cumbria, with more urinary incontinence in North-East and Cumbria and Peninsula, greater sexual problems in West Midlands, and poorer vitality in North-East and Cumbria and West Midlands. Limitations include difficulty identifying clinically significant differences and limited information on pretreatment conditions.
Conclusions: Despite adjustment for treatment, and clinical and sociodemographic factors, quality of survival among prostate cancer survivors varied by area of residence. Adoption of best practice from areas performing well could support enhanced survival quality in poorer performing areas, particularly with regard to bowel problems and vitality, where clinically relevant differences were reported.
Patient summary: We conducted a UK-wide survey of patient's quality of life after treatment for prostate cancer. Outcomes were found to vary depending upon where patients live. Different service providers need to ensure that all prostate cancer patients receive the same follow-up care.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2019 The Author(s). Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) (https://creativecommons.org/licenses/by-nc-nd/4.0/). |
Keywords: | Prostate cancer; Treatment; Patient-reported outcomes; Quality of survival; Regional variation; Cancer Alliances |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cancer and Pathology (LICAP) > Clinical Cancer Research (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Molecular Medicine (LIMM) (Leeds) > Section of Epidemiology and Biostatistics (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Health Economics (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Psychology (Leeds) |
Funding Information: | Funder Grant number Prostate Cancer UK PROMS |
Depositing User: | Symplectic Publications |
Date Deposited: | 18 Apr 2019 08:43 |
Last Modified: | 25 Jun 2023 21:47 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.eururo.2019.04.018 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:145137 |