Abstract
Objectives
To examine the relationship between influential factors and treatment decisions among
men with newly diagnosed prostate cancer (PCa).
Methods
We identified men in the Michigan Urological Surgery Improvement Collaborative registry
diagnosed with localized PCa between 2018-2020 who completed Personal Patient Profile-Prostate.
We analyzed the proportion of active surveillance (AS) between men who stated future
bladder, bowel, and sexual problems (termed influential factors) had “a lot of influence”
on their treatment decisions versus other responses. We also assessed the relationship
between influential factors, confirmatory testing results and choice of AS.
Results
A total of 509 men completed Personal Patient Profile-Prostate. Treatment decisions
aligned with influential factors for 88% of men with favorable risk and 49% with unfavorable
risk PCa. A higher proportion of men who identified bladder, bowel and sexual concerns
as having “a lot of influence” on their treatment decision chose AS, compared with
men with other influential factors, although not statistically significant (44% vs
35%, P = .11). Similar results were also found when men were stratified based on PCa risk
groups (favorable risk: 78% vs 67%; unfavorable risk: 17% vs 9%, respectively). Despite
a small sample size, a higher proportion of men with non-reassuring confirmatory testing
selected AS if influential factors had “a lot of influence” compared to “no influence”
on their treatment decisions.
Conclusion
Men's concerns for future bladder, bowel, and sexual function problems, as elicited
by a decision aid, may help explain treatment selection that differs from traditional
clinical recommendation.
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Article info
Publication history
Published online: April 29, 2021
Accepted:
April 15,
2021
Received:
February 12,
2021
Footnotes
Financial Support: MUSIC is sponsored by Blue Cross Blue Shield of Michigan. The authors acknowledge the support staff at the MUSIC Coordinating Center, the clinical champions, administrators, data abstractors and urologists at each MUSIC contributing practice. Funding from National Institutes of Diabetes and Digestive and Kidney Disease F32 DK126232 also supported this project. No commercial conflicts of interest.
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