Health-related quality of life in patients with screen-detected versus clinically diagnosed prostate cancer preceding primary treatment

BACKGROUND. The purpose of this study was to evaluate baseline health-relat ed quality of life (HRQOL) in patients with localized prostate cancer befor e primary treatment (radical prostatectomy or radiotherapy). METHODS. Two hundred patients with newly diagnosed localized (screen-detest ed or clinically diagnosed) prostate cancer completed HRQOL questionnaires (generic and disease-specific measures). Clinical data were collected from patients' medical records in four Rotterdam hospitals. RESULTS. Screen-detected tumors were of more favorable stages and grades th an clinically diagnosed ones. The diagnostic groups did not differ signific antly in bowel and sexual functioning. Differences were found in urinary fu nctioning, favoring patients with screen-detected tumors of T2-T3 stages, p atients with screen-detected T2 cancer reported better generic HRQOL (physi cal aspects) than the clinical group, but HRQOL of the latter group was sim ilar to the population norm. Radiotherapy patients were significantly older and had more comorbidity than subjects referred to prostatectomy. Urinary, bowel, and sexual problems were uncommon. Older (>65 years) radiotherapy p atients appeared to be less sexually active. Radiotherapy patients also rep orted poorer levels of generic HRQOL. CONCLUSIONS. Screen-detected prostate cancer patients presented with more f avorable cancer stage and grade. HRQOL was related to both the tumor stage and the detection method. Pre-treatment HRQOL differences between prostatec tomy and radiotherapy patients were associated neither with tumor character istics nor with the detection method. Baseline differences in HRQOL should be taken into account when evaluating post-treatment HRQOL. Prostate 46:87- 97, 2001. (C) 2001 Wiley-Liss, Inc.