A large-scale digital survey of patients with localized and advanced prostate cancer in Germany, the UK, and the USA

We conducted a prostate cancer (PC) survey to provide a better understanding of the patient journey, expectations, and attitudes related to treatment. This large-scale digital survey of patients with localized or advanced PC from Germany, the UK, and the USA assessed their demographics, diagnosis, treatment history, perception of therapy, medical care team involvement, and health-related quality of life (HRQoL). The survey was designed and interpreted by a large multistakeholder group. Descriptive statistics were primarily used. Univariate and multivariate analyses of the impact on HRQoL by demographic and clinical factors, including disease and treatment history, were examined using simple and multiple linear regression analyses, respectively. Overall, 15 824 participants completed the survey and 14 812 reported their disease status (79.6% had localized and 20.4% had advanced PC). Across the three countries, there were similarities and differences in diagnosis, treatment patterns, and medical specialists involved. Diagnosis by routine screening was more common in Germany and the USA than in the UK. For localized disease, the most common treatment was prostatectomy in Germany and the USA, and radiotherapy in the UK. Hormone therapy was the most common treatment for advanced disease across countries. Overall, treatment satisfaction was high but decreased over time. Patients not on active treatment generally had negative perceptions of treatment types and their impact on HRQoL. Advanced disease and multiple comorbidities were identified as the predictors of worse HRQoL. This study highlights differences in the PC patient journey in Germany, the UK, and the USA. HRQoL did not differ between countries but was affected by advanced disease status and comorbidity burden. A common approach to PC diagnosis, treatment practices, and guidelines could improve outcomes.