Mazariego C G, Juraskova I, Campbell R, Smith D P
Cancer Research Division, Cancer Council New South Wales, Sydney, Australia.
Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Camperdown, NSW, Australia.
Support Care Cancer. 2020 Nov;28(11):5511-5520. doi: 10.1007/s00520-020-05389-x. Epub 2020 Mar 16.
To determine the prevalence, severity, and baseline associations of self-reported long-term unmet supportive care needs in a population-wide cohort of men with prostate cancer (PC), 15 years post-diagnosis.
Participants were drawn from the New South Wales (NSW) Prostate Cancer Care and Outcomes Study. Eligible men were diagnosed with PC between 2000 and 2002, aged less than 70 years at diagnosis, and completed a 15-year follow-up survey. Demographic and clinical data were collected at baseline. The validated Cancer Survivors' Unmet Needs (CaSUN) Survey was administered to assess unmet needs.
Of 578 eligible men, 351 completed CaSUN. Mean age was 75.8 (range 59-84) with a mean follow-up time of 15.2 years post-diagnosis. Over a third of men (37.4%) reported at least one unmet need at 15 years. Most frequently reported unmet needs pertained to the comprehensive cancer care (34.1%) domain. 87.2% of participants who reported problems with sexual function reported this need as moderate/severe. Higher diagnostic prostate-specific antigen (PSA) levels (20+ ng/mL) at diagnosis were associated with future unmet needs (PSA 20+: OR = 4.80, 95% CI [1.33-17.35]).
Many PC survivors continue to report unmet needs 15 years post-diagnosis. There is a pressing need for clinicians to work together to coordinate PC care, and to proactively, regularly, and openly enquire about men's sexual adjustment to PC. The needs of PC survivors could better be met with more coordinated approaches to multidisciplinary care and timely interventions and support for chronic sexual dysfunction.
确定在一个全人群队列中，前列腺癌（PC）确诊15年后自我报告的长期未满足的支持性护理需求的患病率、严重程度及基线关联。
参与者来自新南威尔士州（NSW）前列腺癌护理与结局研究。符合条件的男性在2000年至2002年间被诊断为PC，诊断时年龄小于70岁，并完成了15年的随访调查。在基线时收集人口统计学和临床数据。采用经过验证的癌症幸存者未满足需求（CaSUN）调查来评估未满足的需求。
在578名符合条件的男性中，351人完成了CaSUN调查。平均年龄为75.8岁（范围59 - 84岁），确诊后平均随访时间为15.2年。超过三分之一的男性（37.4%）在15年时报告至少有一项未满足的需求。最常报告的未满足需求属于综合癌症护理领域（34.1%）。报告性功能问题的参与者中，87.2%表示这种需求为中度/重度。诊断时较高的前列腺特异性抗原（PSA）水平（20 + ng/mL）与未来未满足的需求相关（PSA 20 +：比值比 = 4.80，95%置信区间[1.33 - 17.35]）。
许多PC幸存者在确诊15年后仍报告有未满足的需求。临床医生迫切需要共同努力协调PC护理，并积极、定期且公开地询问男性对PC的性适应情况。通过更协调的多学科护理方法以及对慢性性功能障碍的及时干预和支持，可以更好地满足PC幸存者的需求。
