title: [What do prostate cancer patients know about smoking? : Results of a bicentric questionnaire study (KRAUT study)].
abstract: BACKGROUND
  According to the results of a recent meta-analysis, cancer-specific mortality of prostate cancer (PCA) patients is enhanced by 24 % in case of a positive smoking history with a dose-dependent impact of smoking. Until now it is unknown whether this information actually reaches the patients and how extensively an informational discussion about this topic is pursued by physicians.
  
  
  OBJECTIVE
  Three study hypotheses were defined: (1) the knowledge of PCA patients about the potential relationship between tumor progression and cigarette consumption is low, (2) only in rare cases has a clear statement been provided by treating physicians including the explicit advice to stop smoking, and (3) there was a direct association between tumor stage and the extent of cigarette consumption.
  
  
  METHODS
  A questionnaire comprising 23 items was developed and validated with 25 uro-oncological patients prior to study start. Between September 2013 and December 2014 a total of 124 PCA patients (median age 65 years) from two urology departments were included in this questionnaire-based survey.
  
  
  RESULTS
  The study population comprised 43 % (n = 54), 39 % (n = 48), and 18 % (n = 22) nonsmokers, former smokers and active smokers, respectively. Active and former smokers differed insignificantly in the number of pack-years only (24.8 vs. 23.7 years, p = 0.995). Of the patients, 56 % regarded an influence of cigarette consumption on the PCA-specific prognosis as possible. However, because a significant (p < 0.001) number of patients wrongly suspected smoking to be causative for PCA development, their knowledge about PCA prognosis is supposedly not based on adequate knowledge. Two of 22 active smokers (9.1 %), 5 of 48 former smokers (10.4 %), and 2 of 54 nonsmokers (3.7 %) had an informational discussion with their urologist about the association of cigarette consumption and PCA-related prognosis (a further 9.1, 4.2 and 3.7 %, respectively, received this information solely from other medical specialties). Only 1 of 22 active smokers (4.5 %) was offered medical aids for smoking cessation by the general practitioner; none of the patients received such support by an urologist. There was no association between a positive smoking history or number of pack-years and PCA tumor stage.
  
  
  CONCLUSIONS
  Education of PCA patients about the relationship between cigarette consumption and cancer-related prognosis is currently inadequate. Following the latest findings on this topic, urologists should pursue informational discussions with their patients, thereby strengthening their position as the primary contact person for decision making in PCA management.
authors.affiliation: Urologische Klinik, St. Elisabeth-Klinikum Straubing, St. Elisabeth-Str. 23, 94315, Straubing, Deutschland. matthias.may@klinikum-straubing.de.
authors.forename: M
authors.initials: M
authors.lastname: May
authors.affiliation: Urologische Klinik, St. Elisabeth-Klinikum Straubing, St. Elisabeth-Str. 23, 94315, Straubing, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Gilfrich
authors.affiliation: Urologische Klinik, Universitätsklinikum Regensburg, Caritas-Krankenhaus St. Josef, Regensburg, Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Spachmann
authors.affiliation: Urologische Klinik, St. Elisabeth-Klinikum Straubing, St. Elisabeth-Str. 23, 94315, Straubing, Deutschland.
authors.forename: O
authors.initials: O
authors.lastname: Maurer
authors.affiliation: Urologische Klinik, Universitätsklinikum Regensburg, Caritas-Krankenhaus St. Josef, Regensburg, Deutschland.
authors.forename: M K
authors.initials: MK
authors.lastname: Dombrowski
authors.affiliation: Urologische Klinik, Universitätsklinikum Regensburg, Caritas-Krankenhaus St. Josef, Regensburg, Deutschland.
authors.forename: H M
authors.initials: HM
authors.lastname: Fritsche
authors.affiliation: Urologische Klinik, RoMed Klinikum Rosenheim, Rosenheim, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Wöhr
authors.affiliation: Urologische Klinik, Ludwig-Maximilians-Universität München, München, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Brookman-May
authors.affiliation: Urologische Klinik, St. Elisabeth-Klinikum Straubing, St. Elisabeth-Str. 23, 94315, Straubing, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Karl
authors.affiliation: Urologische Klinik, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Schostak
authors.affiliation: Urologische Klinik, Universitätsklinikum Regensburg, Caritas-Krankenhaus St. Josef, Regensburg, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Burger
authors.affiliation: Urologische Klinik, Ruppiner Kliniken Neuruppin, Neuruppin, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Lebentrau
mesh_terms: D000368:Aged; D005858:Germany / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D015995:Prevalence; D011471:Prostatic Neoplasms / Q000401:mortality*; D012307:Risk Factors; D012907:Smoking / Q000401:mortality*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D015996:Survival Rate
keywords: Cigarette smoking; Informative conversation; Patient survey; Prognosis; Tumor stage