METHODS: We measured patient utility for global health as a part of routine clinical care at the Prostate Centre, Princess Margaret Hospital, Toronto. Patients completed the Patient Oriented PC Utility Scale (PORPUS-Ui), a disease-specific utility instrument. We examined age, stage, and treatment related variations in utility scores.

RESULTS: Mean PORPUS-Ui utility was 0.91 (n=3001). Low energy, urinary frequency, and low sexual function and drive were the most common sources of disutility. Utilities decreased with age, from 0.93 for <60 yr-olds (n=725) to 0.85 for >80 yr-olds (n=251) (p<0.0001). Age related decrements in utility were also observed in patients stratified by treatment history (radical prostatectomy (RP) alone, radiation therapy (RT) alone, both). Patients who had received only RP (n=186) or RT (n=28) had mean (SD) utilities of 0.94(0.08) and 0.9(0.16), respectively, compared with 0.86(0.09) for those who had both treatments (n=65). Mean utility for patients with documented metastatic PC (n=25) was 0.83, compared with 0.93 for those with clearly localized disease (n=665) (p<0.01)

DISCUSSION: Age, stage and treatment history have a substantial effect on preferences for health outcomes in prostate cancer patients. These effects should be incorporated in decision analytic and cost effectiveness models.