Preferences of husbands and wives for outcomes of prostate cancer screening and treatment.
OBJECTIVE
To explore the preferences of male primary care patients and their spouses for the outcomes of prostate cancer screening and treatment, and quality of life with metastatic prostate cancer.


METHODS
Cross-sectional design.


METHODS
Primary care clinics in Galveston County, Texas.


METHODS
One hundred sixty-eight couples in which the husband was a primary care patient and a candidate for prostate cancer screening.


RESULTS
Preferences were measured as utilities for treatment outcomes and quality of life with metastatic disease by the time trade-off method for the husband and the wife individually and then conjointly for the couple. For each health state considered, husbands associated lower utilities for the health states than did their wives. Couples' utilities fell between those of husbands and wives (all comparisons were significant at P <.01). For partial and complete impotence and mild-to-moderate incontinence, the median utility value for the wives was 1.0, indicating that most wives did not associate disutility with their husbands having to experience these treatment complications.


CONCLUSIONS
Male primary care patients who are candidates for prostate cancer screening evaluate the outcomes of prostate cancer treatment and life with advanced prostate cancer as being far worse than do their wives. Because the choice between quantity and quality of life is a highly individualistic one, both the patient and his partner should be involved in making decisions about prostate cancer screening. J
Volk
Robert J
RJ
Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas 77098-3915, USA. bvokl@bcm.tmc.edu
Cantor
Scott B
SB
Cass
Alvah R
AR
Spann
Stephen J
SJ
Weller
Susan C
SC
Krahn
Murray D
MD
D000368:Aged; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000523:psychology / Q000556:secondary / Q000628:therapy*; D011788:Quality of Life; D014549:Urinary Incontinence / Q000209:etiology