Abstract
BackgroundThe long‐term health‐related quality of life (HRQOL) impacts of PCa screening have not been adequately evaluated. We aimed to compare the generic and disease‐specific health‐related quality of life (HRQOL) among men with prostate cancer in the screening arm with the control arm of the PSA‐based prostate cancer screening trial in up to 15 years of follow‐up.Materials and methodsThis study was conducted within population‐based Finnish Randomized Study of Screening for Prostate Cancer (FinRSPC). During 1996‐1999 80,458 men were randomized to the serum prostate‐specific antigen (PSA) screening arm (SA, N = 32 000) and the control arm (CA, N = 48 458). Men in the screening arm were screened at 4‐year intervals until 2007. HRQOL questionnaires were delivered to newly diagnosed prostate cancer patients in the screening and control arm 1996‐2006 (N = 5128) at the time of diagnosis (baseline), at 3‐month, 12‐month and 5, 10, and 15‐year follow‐up. Validated UCLA Prostate Cancer Index (UCLA‐PCI) and RAND 36‐Item Health Survey were used for HRQOL assessment. The data were analyzed with a random effects model for repeated measures.ResultsAt baseline, men with prostate cancer in the screening arm reported better Sexual Function, as well as less Sexual and Urinary Bother. Long‐term follow‐up revealed slightly higher HRQOL scores in the screening arm in prostate cancer specific measures at 10‐year post diagnosis, but the differences were statistically significant only in Urinary Bother (UCLA‐PCI score 77.9; 95% CI 75.2 to 80.5 vs. 70.9; 95% CI 66.8 to 74.9 P = .005). The generic HRQOL scores were comparable between the trial arms. The overall differences in disease‐specific or generic HRQOL scores by trial arm did not vary during the follow‐up.ConclusionNo major differences were observed in HRQOL in men with prostate cancer between the prostate cancer screening and control arms during five to 15‐year follow‐up.
Highlights
Prostate cancer (PCa) is the most common cancer and one of the leading causes of cancer death in men in Western countries.1 Long-term survival following PCa diagnosis is good; age-standardized 5-year survival is in the range 70%-100% in most countries.2 PCa is the main global contributor to years lived with cancer disability3 and men with clinically detected PCa have shown to experience treatment-related adverse effects at 5 years,4 and even up to 10-15 years after diagnosis.5,6European Randomized Study of Screening for Prostate Cancer (ERSPC) has shown reduced incidence of advanced disease,7 and a 20% relative reduction in PCa mortality over 16-year follow-up.8 screening for PCa could potentially offer major benefits, and improve quality of life in men with screen-detected PCa
Evaluation of the long-term health-related quality of life (HRQOL) effects of screening is important for the overall evaluation regarding PCa screening
This study aims to broaden the knowledge of the overall impact of prostate-specific antigen (PSA)-based PCa screening at population level by comparing both generic (RAND-36) and disease-specific (UCLA-PCI) HRQOL among PCa patients in the screening arm and control arm in a randomized trial with 15-year follow-up
Summary
Prostate cancer (PCa) is the most common cancer and one of the leading causes of cancer death in men in Western countries. Long-term survival following PCa diagnosis is good; age-standardized 5-year survival is in the range 70%-100% in most countries. PCa is the main global contributor to years lived with cancer disability and men with clinically detected PCa have shown to experience treatment-related adverse effects at 5 years, and even up to 10-15 years after diagnosis.5,6European Randomized Study of Screening for Prostate Cancer (ERSPC) has shown reduced incidence of advanced disease, and a 20% relative reduction in PCa mortality over 16-year follow-up. screening for PCa could potentially offer major benefits, and improve quality of life in men with screen-detected PCa. Long-term survival following PCa diagnosis is good; age-standardized 5-year survival is in the range 70%-100% in most countries.. Evaluation of the long-term health-related quality of life (HRQOL) effects of screening is important for the overall evaluation regarding PCa screening.. The long-term health-related quality of life (HRQOL) impacts of PCa screening have not been adequately evaluated. We aimed to compare the generic and disease-specific health-related quality of life (HRQOL) among men with prostate cancer in the screening arm with the control arm of the PSA-based prostate cancer screening trial in up to 15 years of follow-up. Long-term follow-up revealed slightly higher HRQOL scores in the screening arm in prostate cancer specific measures at 10-year post diagnosis, but the differences were statistically significant only in Urinary Bother
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