Kendel, F., Helbig, L., Neumann, K., Herden, J., Stephan, C., Schrader, M., & Gaissmaier, W. (2016). Patients’ perceptions of mortality risk for localized prostate cancer vary markedly depending on their treatment strategy. International Journal of Cancer, 139, 749–753. doi: 10.1002/ijc.30123

Treatment choice for localized prostate cancer (PCa) is a controversial issue, and mortality risk is probably the most decisive factor in this regard. The study aimed to compare prostate-cancer-specific mortality risk estimates for different treatment options assigned by patients managed with active surveillance (AS), radical prostatectomy (RP) and patients who had discontinued AS (DAS). Patients initially managed with AS or RP (N = 370) were matched according to length of therapy. All patients completed mailed questionnaires assessing their mortality risk estimates (in %) and prostate-cancer-specific anxiety. Differences in risk estimates among the three treatment groups were analyzed using ANOVA, relationships of clinical and psychosocial variables with risk estimates using standard multiple regression. In all treatment groups, the prostate- cancer-specific mortality risk was overestimated. This applied whether it was the patient's own treatment or the alternative treatment option. RP patients assigned a mortality risk to AS that was almost three times higher than that assigned to RP (50.9 ± 25.0 vs. 17.8 ± 19.7, d = 1.48; p

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Keywords: active surveillance; anxiety; localized prostate cancer; mortality risk estimates; radical prostatectomy