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Quality of life among symptomatic compared to PSA-detected prostate cancer survivors-results from a UK wide patient-reported outcomes study

Lookup NU author(s): Professor Linda Sharp



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2019 The Author(s).Background: Quality of life among prostate cancer survivors varies by socio-demographic factors and treatment type received; however, less in known about differences in functional outcomes by method of presentation. We investigate differences in reported urinary, bowel, sexual and hormone-related problems between symptomatic and PSA-detected prostate cancer survivors. Methods: A UK wide cross-sectional postal survey of prostate cancer survivors conducted 18-42 months post-diagnosis. Questions were included on presentation method and treatment. Functional outcome was determined using the EPIC-26 questionnaire. Reported outcomes were compared for symptomatic and PSA-detected survivors using ANOVA and multivariable log-linear regression. Results: Thirty-five thousand eight hundred twenty-three men responded (response rate: 60.8%). Of these, 31.3% reported presenting via PSA test and 59.7% symptomatically. In multivariable analysis, symptomatic men reported more difficulty with urinary incontinence (Adjusted mean ratio (AMR): 0.96, 95% CI: 0.96-0.97), urinary irritation (AMR: 0.95, 95% CI: 0.95-0.96), bowel function (AMR: 0.97, 95% CI: 0.97-0.98), sexual function (AMR: 0.90, 95% CI: 0.88-0.92), and vitality/hormonal function (AMR: 0.96, 95% CI: 0.96-0.96) than PSA-detected men. Differences were consistent across respondents of differing age, stage, Gleason score and treatment type. Conclusion: Prostate cancer survivors presenting symptomatically report poorer functional outcomes than PSA-detected survivors. Differences were not explained by socio-demographic or clinical factors. Clinicians should be aware that men presenting with symptoms are more likely to report functional difficulties after prostate cancer treatment and may need additional aftercare if these difficulties persist. Method of presentation should be considered as a covariate in patient-reported outcome studies of prostate cancer.

Publication metadata

Author(s): Donnelly DW, Vis LC, Kearney T, Sharp L, Bennett D, Wilding S, Downing A, Wright P, Watson E, Wagland R, Cross WR, Mason MD, Siesling S, Van Manen JG, Glaser AW, Gavin A

Publication type: Article

Publication status: Published

Journal: BMC Cancer

Year: 2019

Volume: 19

Online publication date: 15/10/2019

Acceptance date: 16/09/2019

Date deposited: 19/06/2020

ISSN (electronic): 1471-2407

Publisher: BioMed Central Ltd.


DOI: 10.1186/s12885-019-6164-5

PubMed id: 31615476


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