Regional Variations in Quality of Survival Among Men with Prostate Cancer Across the United Kingdom

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

doi:10.1016/j.eururo.2019.04.018

Regional Variations in Quality of Survival Among Men with Prostate Cancer Across the United Kingdom

David Donnelly, Anna Gavin, Amy Downing, Luke Hounsome, Therese Kearney, Emma McNair, Dawn Allan, Dyfed Huws, Penny Wright, Peter J Selby, Paul Kind, Eila Watson, Richard Wagland, Sarah Wilding, Hugh Butcher, Rebecca Mottram, Marjorie Allen, Oonagh McSorley, Sharpe Linda, Malcolm D MasonWilliam R Cross, James W F Catto, Adam W Glaser

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Abstract

AbstractPurpose: Prostate cancer incidence, treatment and survival rates vary throughout the United Kingdom (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 months previously.Outcome measurements and statistical analysis: Urinary, bowel, sexual problems and vitality were patient reported using the EPIC-26 questionnaire. General health was also self-assessed. Regional variations were identified using multivariable log-linear regression. Results and limitations: 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 & Cumbria, with more urinary incontinence in North-East & Cumbria and Peninsula, greater sexual problems in West Midlands and poorer vitality in North-East & Cumbria and West Midlands. Limitations include difficulty identifying clinically significant differences and limited information on pre-treatment conditions.Conclusions: Despite adjustment for treatment, clinical and socio-demographic 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 regards 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.

Original language	English
Number of pages	10
Journal	European Urology
Early online date	04 May 2019
DOIs	https://doi.org/10.1016/j.eururo.2019.04.018
Publication status	Published - 01 Jul 2019

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Regional Variations in Quality of Survival Among Men with Prostate Cancer Across the United Kingdom
© 2019 The Authors. This is an open access article published under a Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits distribution and reproduction for non-commercial purposes, provided the author and source are cited.
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Donnelly, D., Gavin, A., Downing, A., Hounsome, L., Kearney, T., McNair, E., Allan, D., Huws, D., Wright, P., Selby, P. J., Kind, P., Watson, E., Wagland, R., Wilding, S., Butcher, H., Mottram, R., Allen, M., McSorley, O., Linda, S., ... Glaser, A. W. (2019). Regional Variations in Quality of Survival Among Men with Prostate Cancer Across the United Kingdom. European Urology. https://doi.org/10.1016/j.eururo.2019.04.018

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title = "Regional Variations in Quality of Survival Among Men with Prostate Cancer Across the United Kingdom",

abstract = "AbstractPurpose: Prostate cancer incidence, treatment and survival rates vary throughout the United Kingdom (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 months previously.Outcome measurements and statistical analysis: Urinary, bowel, sexual problems and vitality were patient reported using the EPIC-26 questionnaire. General health was also self-assessed. Regional variations were identified using multivariable log-linear regression. Results and limitations: 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 & Cumbria, with more urinary incontinence in North-East & Cumbria and Peninsula, greater sexual problems in West Midlands and poorer vitality in North-East & Cumbria and West Midlands. Limitations include difficulty identifying clinically significant differences and limited information on pre-treatment conditions.Conclusions: Despite adjustment for treatment, clinical and socio-demographic 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 regards bowel problems and vitality, where clinically relevant differences were reported.Patient summary: We conducted a UK-wide survey of patient{\textquoteright}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.",

author = "David Donnelly and Anna Gavin and Amy Downing and Luke Hounsome and Therese Kearney and Emma McNair and Dawn Allan and Dyfed Huws and Penny Wright and Selby, {Peter J} and Paul Kind and Eila Watson and Richard Wagland and Sarah Wilding and Hugh Butcher and Rebecca Mottram and Marjorie Allen and Oonagh McSorley and Sharpe Linda and Mason, {Malcolm D} and Cross, {William R} and Catto, {James W F} and Glaser, {Adam W}",

year = "2019",

month = jul,

day = "1",

doi = "10.1016/j.eururo.2019.04.018",

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journal = "European Urology",

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Donnelly, D, Gavin, A, Downing, A, Hounsome, L, Kearney, T, McNair, E, Allan, D, Huws, D, Wright, P, Selby, PJ, Kind, P, Watson, E, Wagland, R, Wilding, S, Butcher, H, Mottram, R, Allen, M, McSorley, O, Linda, S, Mason, MD, Cross, WR, Catto, JWF & Glaser, AW 2019, 'Regional Variations in Quality of Survival Among Men with Prostate Cancer Across the United Kingdom', European Urology. https://doi.org/10.1016/j.eururo.2019.04.018

TY - JOUR

T1 - Regional Variations in Quality of Survival Among Men with Prostate Cancer Across the United Kingdom

AU - Donnelly, David

AU - Gavin, Anna

AU - Downing, Amy

AU - Hounsome, Luke

AU - Kearney, Therese

AU - McNair, Emma

AU - Allan, Dawn

AU - Huws, Dyfed

AU - Wright, Penny

AU - Selby, Peter J

AU - Kind, Paul

AU - Watson, Eila

AU - Wagland, Richard

AU - Wilding, Sarah

AU - Butcher, Hugh

AU - Mottram, Rebecca

AU - Allen, Marjorie

AU - McSorley, Oonagh

AU - Linda, Sharpe

AU - Mason, Malcolm D

AU - Cross, William R

AU - Catto, James W F

AU - Glaser, Adam W

PY - 2019/7/1

Y1 - 2019/7/1

N2 - AbstractPurpose: Prostate cancer incidence, treatment and survival rates vary throughout the United Kingdom (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 months previously.Outcome measurements and statistical analysis: Urinary, bowel, sexual problems and vitality were patient reported using the EPIC-26 questionnaire. General health was also self-assessed. Regional variations were identified using multivariable log-linear regression. Results and limitations: 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 & Cumbria, with more urinary incontinence in North-East & Cumbria and Peninsula, greater sexual problems in West Midlands and poorer vitality in North-East & Cumbria and West Midlands. Limitations include difficulty identifying clinically significant differences and limited information on pre-treatment conditions.Conclusions: Despite adjustment for treatment, clinical and socio-demographic 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 regards 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.

AB - AbstractPurpose: Prostate cancer incidence, treatment and survival rates vary throughout the United Kingdom (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 months previously.Outcome measurements and statistical analysis: Urinary, bowel, sexual problems and vitality were patient reported using the EPIC-26 questionnaire. General health was also self-assessed. Regional variations were identified using multivariable log-linear regression. Results and limitations: 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 & Cumbria, with more urinary incontinence in North-East & Cumbria and Peninsula, greater sexual problems in West Midlands and poorer vitality in North-East & Cumbria and West Midlands. Limitations include difficulty identifying clinically significant differences and limited information on pre-treatment conditions.Conclusions: Despite adjustment for treatment, clinical and socio-demographic 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 regards 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.

U2 - 10.1016/j.eururo.2019.04.018

DO - 10.1016/j.eururo.2019.04.018

M3 - Article

SN - 0302-2838

JO - European Urology

JF - European Urology

ER -

Regional Variations in Quality of Survival Among Men with Prostate Cancer Across the United Kingdom

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