Patient-Reported Psychological and Prostate Cancer-Specific Functional Outcomes Among Men With Low-Risk Prostate Cancer Two Years After Diagnosis: The PREPARE Prospective Cohort Study.

[OBJECTIVE] To compare general anxiety and prostate cancer (PCa)-specific anxiety and PCa-specific functioning reported at 24 months after diagnosis between men who initially chose and remained on active surveillance (AS), those who initially chose active treatment (AT), and those who initially chose AS but later switched to AT (Delayed AT).

[METHODS] We conducted telephone interviews (N = 1139) after initial diagnosis (but before treatment) and follow-up interviews 2 years thereafter (N = 950; 87.1%). We assessed anxiety (general and PCa-specific) and PCa-specific function, comparing AS (N = 442), AT (N = 420), and Delayed AT (N = 88) at 24 months using multivariable linear regression.

[RESULTS] Adjusting for pre-treatment anxiety, clinical, and sociodemographic factors, the AS group reported higher general anxiety (mean = 48.4) than the AT group (mean = 46.5, P = .01) but did not differ from the Delayed AT group (mean = 48.7, P = .76). The AS group also reported higher PCa-specific anxiety (mean = 10.9) compared to both treatment groups (9.2, P<.0001). However, the AS group reported significantly better PCa-related outcomes than either treatment group for urinary incontinence, sexual function, and bowel function (all P-values <.01).

[CONCLUSION] At 2 years after diagnosis, men who remained on AS reported significantly higher general anxiety than the AT group, and significantly higher PCa-specific anxiety compared to the AT or Delayed AT groups. Our findings highlight the importance of assessing general and prostate-specific anxiety alongside physical functioning to help tailor disease management for men with low-risk PCa.