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Prostate Cancer Patient Characteristics Associated With a Strong Preference to Preserve Sexual Function and Receipt of Active Surveillance.

Publication ,  Journal Article
Broughman, JR; Basak, R; Nielsen, ME; Reeve, BB; Usinger, DS; Spearman, KC; Godley, PA; Chen, RC
Published in: J Natl Cancer Inst
April 1, 2018

BACKGROUND: Men with early-stage prostate cancer have multiple options that have similar oncologic efficacy but vary in terms of their impact on quality of life. In low-risk cancer, active surveillance is the option that best preserves patients' sexual function, but it is unknown if patient preference affects treatment selection. Our objectives were to identify patient characteristics associated with a strong preference to preserve sexual function and to determine whether patient preference and baseline sexual function level are associated with receipt of active surveillance in low-risk cancer. METHODS: In this population-based cohort of men with localized prostate cancer, baseline patient-reported sexual function was assessed using a validated instrument. Patients were also asked whether preservation of sexual function was very, somewhat, or not important. Prostate cancer disease characteristics and treatments received were abstracted from medical records. A modified Poisson regression model with robust standard errors was used to compute adjusted risk ratio (aRR) estimates. All statistical tests were two-sided. RESULTS: Among 1194 men, 52.6% indicated a strong preference for preserving sexual function. Older men were less likely to have a strong preference (aRR = 0.98 per year, 95% confidence interval [CI] = 0.97 to 0.99), while men with normal sexual function were more likely (vs poor function, aRR = 1.59, 95% CI = 1.39 to 1.82). Among 568 men with low-risk cancer, there was no clear association between baseline sexual function or strong preference to preserve function with receipt of active surveillance. However, strong preference may differnetially impact those with intermediate baseline function vs poor function (Pinteraction = .02). CONCLUSIONS: Treatment choice may not always align with patients' preferences. These findings demonstrate opportunities to improve delivery of patient-centered care in early prostate cancer.

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Published In

J Natl Cancer Inst

DOI

EISSN

1460-2105

Publication Date

April 1, 2018

Volume

110

Issue

4

Start / End Page

420 / 425

Location

United States

Related Subject Headings

  • Watchful Waiting
  • Surveys and Questionnaires
  • Sexual Behavior
  • Quality of Life
  • Prostatic Neoplasms
  • Prostatectomy
  • Prognosis
  • Patient Preference
  • Oncology & Carcinogenesis
  • Middle Aged
 

Citation

APA
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Broughman, J. R., Basak, R., Nielsen, M. E., Reeve, B. B., Usinger, D. S., Spearman, K. C., … Chen, R. C. (2018). Prostate Cancer Patient Characteristics Associated With a Strong Preference to Preserve Sexual Function and Receipt of Active Surveillance. J Natl Cancer Inst, 110(4), 420–425. https://doi.org/10.1093/jnci/djx218
Broughman, James R., Ramsankar Basak, Matthew E. Nielsen, Bryce B. Reeve, Deborah S. Usinger, Kiayni C. Spearman, Paul A. Godley, and Ronald C. Chen. “Prostate Cancer Patient Characteristics Associated With a Strong Preference to Preserve Sexual Function and Receipt of Active Surveillance.J Natl Cancer Inst 110, no. 4 (April 1, 2018): 420–25. https://doi.org/10.1093/jnci/djx218.
Broughman JR, Basak R, Nielsen ME, Reeve BB, Usinger DS, Spearman KC, et al. Prostate Cancer Patient Characteristics Associated With a Strong Preference to Preserve Sexual Function and Receipt of Active Surveillance. J Natl Cancer Inst. 2018 Apr 1;110(4):420–5.
Broughman, James R., et al. “Prostate Cancer Patient Characteristics Associated With a Strong Preference to Preserve Sexual Function and Receipt of Active Surveillance.J Natl Cancer Inst, vol. 110, no. 4, Apr. 2018, pp. 420–25. Pubmed, doi:10.1093/jnci/djx218.
Broughman JR, Basak R, Nielsen ME, Reeve BB, Usinger DS, Spearman KC, Godley PA, Chen RC. Prostate Cancer Patient Characteristics Associated With a Strong Preference to Preserve Sexual Function and Receipt of Active Surveillance. J Natl Cancer Inst. 2018 Apr 1;110(4):420–425.
Journal cover image

Published In

J Natl Cancer Inst

DOI

EISSN

1460-2105

Publication Date

April 1, 2018

Volume

110

Issue

4

Start / End Page

420 / 425

Location

United States

Related Subject Headings

  • Watchful Waiting
  • Surveys and Questionnaires
  • Sexual Behavior
  • Quality of Life
  • Prostatic Neoplasms
  • Prostatectomy
  • Prognosis
  • Patient Preference
  • Oncology & Carcinogenesis
  • Middle Aged