15250-m-cuypers

49 HRQoL changes prior to Pca treatment onset 3 1. BACKGROUND An aging population and increased use of prostate cancer (Pca) screening contribute to a growth in Pca detection in The Netherlands and other Western countries 1-3 . When Pca is suspected, patients undergo prostate biopsy 4 . InThe Netherlands only, at least 25,000 Dutch men undergo this procedure every year, resulting in approximately 10,000 Pca diagnoses (Netherlands Cancer Registry, 2015) 5 . The largest proportion of Pca diagnoses consist of localized cancer (stage I or II), for which surgery, radiotherapy (either brachy or external beam), and active surveillance (AS) are seen as equally acceptable treatments 4, 6 . However, adverse effects from treatment can impair patients’ health-related quality of life (HRQoL) 7-10 . Common side-effects from treatments with curative intent (surgery, radiotherapy) include sexual, urinary and bowel-related complaints 9, 11 , while AS can increase anxiety symptoms due to postponing treatment 12, 13 . Therefore, impact on HRQoL is an important factor when considering treatment options 14-16 . Changes in HRQoL after Pca treatment are well described, and generally consist of a major decline in HRQoL in the first 1-2 years after treatment 9, 17-19 . Besides the consequences of treatment, changes in HRQoL are related to psychological factors. Optimism and self-efficacy are associated with better HRQoL outcomes, while anxiety, depression and personality traits (e.g. neuroticism, distress) are associated with worse HRQoL outcomes 20-23 . However, most of these studies measured HRQoL from diagnosis onwards, lacking a pre-diagnosis baseline to also capture the psychological burden from prostate biopsy, receiving a Pca diagnosis, and treatment selection. Studies that did take a pre-diagnosis baseline, focused on a specific (older) patient population and did not measure immediately before and after diagnosis 24, 25 . To increase our understanding about the impact of Pca on HRQoL, including receiving a Pca diagnosis and choosing treatment, this study measured HRQoL pre-biopsy and post treatment decision-making. Our hypothesis was that a significant decline in HRQoL would already appear prior to treatment onset from the psychological burden of diagnosis and treatment decision-making. Moreover, we expected changes in HRQoL would be associated with psychological factors (personality traits, optimism, and self- efficacy).