Age-specific health-related quality of life in disease-free long-term prostate cancer survivors versus male population controls—results from a population-based study

  • Salome Adam
  • Daniela Doege
  • Lena Koch-Gallenkamp
  • Melissa S. Y. Thong
  • Heike Bertram
  • Andrea Eberle
  • Bernd Holleczek
  • Ron Pritzkuleit
  • Mechthild Waldeyer-Sauerland
  • Annika Waldmann
  • Sylke Ruth Zeissig
  • Lina Jansen
  • Sabine Rohrmann
  • Hermann Brenner
  • Volker ArndtEmail author
Original Article



Prostate cancer (PC) and its treatment may affect PC survivors differently with respect to age. However, little is known regarding age-specific health-related quality of life (HRQoL) in PC survivors 5 years or even ≥ 10 years post-diagnosis.


The sample included 1975 disease-free PC survivors (5–16 years post-diagnosis) and 661 cancer-free population controls, recruited from two German population-based studies (CAESAR+, LinDe). HRQoL in both populations was assessed using the EORTC QLQ-C30 questionnaire. Additionally, PC survivors completed the PC-specific EORTC QLQ-PR25 questionnaire. Differences in HRQoL between survivors and controls, as well as differences according to age and time since diagnosis were analyzed with multiple regression after adjustment for age, education, stage, and time since diagnosis, where appropriate.


In general, PC survivors reported HRQoL and symptom-burden levels comparable to the general population, except for significantly poorer social functioning and higher burden for diarrhea and constipation. In age-specific analyses, PC survivors up to 69 years indicated poorer global health and social functioning than population controls. Stratification by time since diagnosis revealed little difference between the subgroups. On PC-specific symptoms, burden was highest for urinary bother and symptoms, and lowest for bowel symptoms. Younger age was associated with less urinary symptoms but higher urinary bother.


Long-term disease-free PC survivors reported overall good HRQoL, but experienced persistent specific detriments. Our data suggest that these detriments do not improve substantially with increasing time since diagnosis. Targeted interventions are recommended to prevent PC-related and treatment-related symptoms becoming chronic and to enhance social functioning.


Prostate cancer Health-related quality of life Long-term survivor Population-based 



We thank all cancer survivors and doctors, who participated in the research.

Funding information

The work of Salome Adam was supported by a fellowship grant of the Béatrice Ederer-Weber Stiftung. The CAESAR+ study was supported by a grant from the German Cancer Aid [No. 108262]. The LinDe study was supported by a grant from the German Cancer Aid [No. 110231]. The funding sources were neither involved in the collection, interpretation, and analysis of the data, nor in the decision for the writing and submission of this report for publication.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest. Authors declare that they have full control over all primary data and that the journal may review their data if required.

Ethical consent

Ethical approvals for both studies were obtained from the internal review board (ethics committee) of the medical faculty of the University of Heidelberg and by all review boards accountable for the participating cancer registries. Written informed consent was obtained from all participants. All procedures involving human participants were in accordance with the Helsinki Declaration of 1975, as revised in 1983.

Supplementary material

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ESM 1 (DOCX 137 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Salome Adam
    • 1
    • 2
  • Daniela Doege
    • 2
  • Lena Koch-Gallenkamp
    • 3
  • Melissa S. Y. Thong
    • 2
  • Heike Bertram
    • 4
  • Andrea Eberle
    • 5
  • Bernd Holleczek
    • 6
  • Ron Pritzkuleit
    • 7
  • Mechthild Waldeyer-Sauerland
    • 8
  • Annika Waldmann
    • 8
    • 9
  • Sylke Ruth Zeissig
    • 10
  • Lina Jansen
    • 3
  • Sabine Rohrmann
    • 2
  • Hermann Brenner
    • 3
    • 11
    • 12
  • Volker Arndt
    • 1
    Email author
  1. 1.Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging ResearchGerman Cancer Research Center (DKFZ)HeidelbergGermany
  2. 2.Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention InstituteUniversity of ZurichZurichSwitzerland
  3. 3.Division of Clinical Epidemiology and Aging ResearchGerman Cancer Research Center (DKFZ)HeidelbergGermany
  4. 4.Cancer Registry of North Rhine-WestphaliaBochumGermany
  5. 5.Bremen Cancer Registry, Leibniz Institute for Prevention Research and Epidemiology – BIPSBremenGermany
  6. 6.Saarland Cancer RegistrySaarbrückenGermany
  7. 7.Schleswig-Holstein Cancer RegistryLübeckGermany
  8. 8.Hamburg Cancer RegistryHamburgGermany
  9. 9.Institute of Social Medicine and EpidemiologyUniversity LübeckLübeckGermany
  10. 10.Cancer Registry of Rhineland-PalatinateMainzGermany
  11. 11.Division of Preventive OncologyGerman Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT)HeidelbergGermany
  12. 12.German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ)HeidelbergGermany

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