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Clinical Trial
. 2022 Jul 18;22(1):110.
doi: 10.1186/s12894-022-01062-z.

Cross-cultural differences in men on active surveillance' anxiety: a longitudinal comparison between Italian and Dutch patients from the Prostate cancer Research International Active Surveillance study

Paola Dordoni  1 , Sebastiaan Remmers  2 , Riccardo Valdagni  1   3   4 , Lara Bellardita  1 , Letizia De Luca  1 , Fabio Badenchini  1 , Cristina Marenghi  1 , Monique J Roobol  2 , Lionne D F Venderbos  5
Affiliations
Clinical Trial

Cross-cultural differences in men on active surveillance' anxiety: a longitudinal comparison between Italian and Dutch patients from the Prostate cancer Research International Active Surveillance study

Paola Dordoni et al. BMC Urol. .

Abstract

Background: Men diagnosed with localized prostate cancer (PCa) on active surveillance (AS) have shown to cope with anxiety caused by living with an 'untreated cancer' and different factors can influence the tolerance level for anxiety in these patients. The present study analyzes Italian (Milan) and Dutch (Rotterdam) men prospectively included in the Prostate cancer International Active Surveillance (PRIAS) trial, aiming to explore whether socio-demographic factors (i.e. age, relationship status, education, nationality) may be relevant factors in conditioning the level of anxiety at AS entry and over time.

Methods: Italian and Dutch men participating in the IRB-approved PRIAS study, after signing an informed consent, filled in the Memorial Anxiety Scale for PCa (MAX-PC) at multiple time points after diagnosis. A linear mixed model was used to assess the relationship between the level of patient's anxiety and time spent on AS, country of origin, the interaction between country and time on AS, patients' relationship status and education, on PCa anxiety during AS.

Results: 823 MAX-PC questionnaires were available for Italian and 307 for Dutch men, respectively. Median age at diagnosis was 64 years (IQR 60-70 years) and did not differ between countries. On average, Dutch men had a higher total MAX-PC score than Italian men. However, the level of their anxiety decreased over time. Dutch men on average had a higher score on the PCa anxiety sub-domain, which did not decrease over time. Minimal differences were observed in the sub-domains PSA anxiety and fear of recurrence.

Conclusion: Significant differences in PCa anxiety between the Italian and Dutch cohorts were observed, the latter group of men showing higher overall levels of anxiety. These differences were not related to the socio-demographic factors we studied. Although both PRIAS-centers are dedicated AS-centers, differences in PCa-care organization (e.g. having a multidisciplinary team) may have contributed to the observed different level of anxiety at the start and during AS. Trial registration This study is registered in the Dutch Trial Registry ( www.trialregister.nl ) under NL1622 (registration date 11-03-2009), 'PRIAS: Prostate cancer Research International: Active Surveillance-guideline and study for the expectant management of localized prostate cancer with curative intent'.

Keywords: Active surveillance; Anxiety; Cross cultural; Prostate cancer.

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Conflict of interest statement

The authors declare that they have no competing interests.

References

    1. Bellardita L, Dordoni P, De Luca L, Delor JPM, Valdagni R. Better-informed decision-making to optimize patient selection. In: Klotz L, editor. Active surveillance for localized prostate cancer. Cham: Humana Press; 2018. pp. 149–167.
    1. Menichetti J, De Luca L, Dordoni P, Donegani S, Marenghi C, Valdagni R, Bellardita L. Making Active Surveillance a path towards health promotion: a qualitative study on prostate cancer patients' perceptions of health promotion during Active Surveillance. Eur J Cancer Care. 2019;28(3):e13014. doi: 10.1111/ecc.13014. - DOI - PubMed
    1. Marenghi C, Alvisi MF, Palorini F, Avuzzi B, Badenchini F, Bedini N, Bellardita L, Biasoni D, Bosetti D, Casale A, Catanzaro M, Colecchia M, De Luca L, Donegani S, Dordoni P, Lanocita R, Maffezzini M, Magnani T, Menichetti J, Messina A, Morlino S, Paolini B, Rancati T, Stagni S, Tesone A, Torelli T, Tulli Baldoin E, Vaiani M, Villa S, Villa S, Zaffaroni N, Nicolai N, Salvioni R, Valdagni R. Eleven-year management of prostate cancer patients on active surveillance: what have we learned? Tumori J. 2017;103(5):464–474. doi: 10.5301/tj.5000649. - DOI - PMC - PubMed
    1. Reyna VF, Nelson WL, Han PK, Pignone MP. Decision making and cancer. Am Psychol. 2015;70(2):105. doi: 10.1037/a0036834. - DOI - PMC - PubMed
    1. Klotz L, Vesprini D, Sethukavalan P, Jethava V, Zhang L, Jain S, Yamamoto T, Mamedov A, Loblaw A. Long-term follow-up of a large active surveillance cohort of patients with prostate cancer. J Clin Oncol. 2015;33:272–277. doi: 10.1200/JCO.2014.55.1192. - DOI - PubMed

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