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Regional variations in quality of survival among men with prostate cancer across the United Kingdom

Regional variations in quality of survival among men with prostate cancer across the United Kingdom
Regional variations in quality of survival among men with prostate cancer across the United Kingdom
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.

0302-2838
228-237
Donnelly, David W.
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Gavin, Anna
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Downing, Amy
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Hounsome, Luke
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Kearney, Therese
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McNair, Emma
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Allan, Dawn
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Huws, Dyfed W.
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Wright, Penny
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Selby, Peter J.
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Kind, Paul
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Watson, Eila
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Wagland, Richard
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Wilding, Sarah
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Butcher, Hugh
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Mottram, Rebecca
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Allen, Majorie
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McSorley, Oonagh
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Sharp, Linda
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Mason, Malcolm D.
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Cross, William R
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Catto, James WF
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Glaser, Adam W.
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Donnelly, David W.
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Gavin, Anna
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Downing, Amy
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Hounsome, Luke
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Kearney, Therese
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McNair, Emma
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Allan, Dawn
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Huws, Dyfed W.
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Wright, Penny
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Selby, Peter J.
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Kind, Paul
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Watson, Eila
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Wagland, Richard
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Wilding, Sarah
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Butcher, Hugh
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Mottram, Rebecca
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Allen, Majorie
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McSorley, Oonagh
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Sharp, Linda
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Mason, Malcolm D.
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Cross, William R
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Catto, James WF
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Glaser, Adam W.
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Donnelly, David W., Gavin, Anna, Downing, Amy, Hounsome, Luke, Kearney, Therese, McNair, Emma, Allan, Dawn, Huws, Dyfed W., Wright, Penny, Selby, Peter J., Kind, Paul, Watson, Eila, Wagland, Richard, Wilding, Sarah, Butcher, Hugh, Mottram, Rebecca, Allen, Majorie, McSorley, Oonagh, Sharp, Linda, Mason, Malcolm D., Cross, William R, Catto, James WF and Glaser, Adam W. (2019) Regional variations in quality of survival among men with prostate cancer across the United Kingdom. European Urology, 76 (2), 228-237. (doi:10.1016/j.eururo.2019.04.018).

Record type: Article

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.

Text
Regional Variations in Quality of Survival Among Men with Prostate Cancer Across the UK - Accepted Manuscript
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More information

Accepted/In Press date: 12 April 2019
e-pub ahead of print date: 4 May 2019
Published date: August 2019

Identifiers

Local EPrints ID: 430508
URI: http://eprints.soton.ac.uk/id/eprint/430508
ISSN: 0302-2838
PURE UUID: 11142f4b-006d-41bc-b44a-052e8a8b625a
ORCID for Richard Wagland: ORCID iD orcid.org/0000-0003-1825-7587

Catalogue record

Date deposited: 02 May 2019 16:30
Last modified: 11 May 2024 04:02

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Contributors

Author: David W. Donnelly
Author: Anna Gavin
Author: Amy Downing
Author: Luke Hounsome
Author: Therese Kearney
Author: Emma McNair
Author: Dawn Allan
Author: Dyfed W. Huws
Author: Penny Wright
Author: Peter J. Selby
Author: Paul Kind
Author: Eila Watson
Author: Richard Wagland ORCID iD
Author: Sarah Wilding
Author: Hugh Butcher
Author: Rebecca Mottram
Author: Majorie Allen
Author: Oonagh McSorley
Author: Linda Sharp
Author: Malcolm D. Mason
Author: William R Cross
Author: James WF Catto
Author: Adam W. Glaser

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