title: Localized prostate cancer in Norway, the United States, and Spain: between-country differences of variables before treatment among patients eligible for curative treatment.
abstract: BACKGROUND
  In men with PCa, large variations of PROs after RP or high-dose RAD might be related to between-country differences of medical and sociodemographic variables, and differences in PROs before treatment in the sexual and urinary domains.
  
  
  METHODS
  In 1908 patients with localized PCa from Norway, the United States, or Spain, the relation between medical (prostate-specific antigen, Gleason score, cT-category) and sociodemographic variables (age, education, marital status) before treatment was investigated. Using the Expanded Prostate Cancer Index Composite questionnaire, PROs before treatment within the sexual and urinary domains were also considered.
  
  
  RESULTS
  Compared with the European patients, American patients were younger, fewer had comorbid conditions, and more had a high education level. Fifty-three percent of the US men eligible for RP had low-risk tumors compared with 42% and 31% among the Norwegian and the Spanish patients, respectively. Among the Spanish RAD patients, 54% had had low-risk tumors compared with 34% of the American and 21% of the Norwegian men planned for RAD, respectively. Compared with the European patients, significantly fewer US patients reported moderate or severe sexual dysfunction and related problems. In most subgroups, the number of patients with sexual or urinary dysfunction exceeded that of patients with bother related to the reported dysfunction.
  
  
  CONCLUSIONS
  Statistically significant between-country differences were observed in medical and sociodemographic variables, and in PROs before treatment within the sexual and urinary domains. Large differences between reported dysfunction and related problems within the sexual and urinary domains indicate that dysfunction and bother should be reported separately in addition to calculation of summary scores. The documented differences, not at least regarding PROs, might in part explain the large variation of side effects after treatment evident in the medical literature.
authors: Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway.
authors: Anne Holck
authors: AH
authors: Storås
authors: Department of Urology, Emory University Hospital, Atlanta, GA.
authors: Martin G
authors: MG
authors: Sanda
authors: Health Services Research Group, IMIM (Hospital del Mar Research Institute), Barcelona, Spain.
authors: Montse
authors: M
authors: Ferrer
authors: Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
authors: Jon Håvard
authors: JH
authors: Loge
authors: Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
authors: Alv A
authors: AA
authors: Dahl
authors: Department of ENT, Division of Surgery, Akershus University Hospital, Lorenskog, Norway.
authors: Eivind A S
authors: EA
authors: Steinsvik
authors: Department of Radiation Oncology, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain.
authors: Ferran
authors: F
authors: Guedea
authors: Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway.
authors: Milada
authors: M
authors: Cvancarova
authors: Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway. Electronic address: sdf@ous-hf.no.
authors: Sophie D
authors: SD
authors: Fosså
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009664:Norway / Q000453:epidemiology; D011379:Prognosis; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D011788:Quality of Life; D011878:Radiotherapy; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014549:Urinary Incontinence / Q000209:etiology
keywords: Between-country variables; Curative treatment; Prostate cancer; Radical prostatectomy; Radiotherapy