Clinical Study

BJC Open article

British Journal of Cancer (2013) 109, 633–640. doi:10.1038/bjc.2013.370
Published online 16 July 2013

Patients’ and urologists’ preferences for prostate cancer treatment: a discrete choice experiment

E W de Bekker-Grob1, M C J Bliemer2, B Donkers3, M-L Essink-Bot4, I J Korfage1, M J Roobol5, C H Bangma5 and E W Steyerberg1

  1. 1Department of Public Health, Erasmus MC—University Medical Centre Rotterdam, PO Box 2040, Rotterdam, The Netherlands
  2. 2Institute of Transport and Logistics Studies, University of Sydney, Sydney, New South Wales, Australia
  3. 3Department of Business Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands
  4. 4Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
  5. 5Department of Urology, Erasmus MC—University Medical Centre Rotterdam, Rotterdam, The Netherlands

Correspondence: Dr EW de Bekker-Grob, ; E-mail:

Received 3 March 2013; Revised 19 June 2013; Accepted 22 June 2013
Advance online publication 16 July 2013





Patients’ preferences are important for shared decision making. Therefore, we investigated patients’ and urologists’ preferences for treatment alternatives for early prostate cancer (PC).



A discrete choice experiment was conducted among 150 patients who were waiting for their biopsy results, and 150 urologists. Regression analysis was used to determine patients’ and urologists’ stated preferences using scenarios based on PC treatment modality (radiotherapy, surgery, and active surveillance (AS)), and risks of urinary incontinence and erectile dysfunction.



The response rate was 110 out of 150 (73%) for patients and 50 out of 150 (33%) for urologists. Risk of urinary incontinence was an important determinant of both patients’ and urologists’ stated preferences for PC treatment (P<0.05). Treatment modality also influenced patients’ stated preferences (P<0.05), whereas the risk of erectile dysfunction due to radiotherapy was mainly important to urologists (P<0.05). Both patients and urologists preferred AS to radical treatment, with the exception of patients with anxious/depressed feelings who preferred radical treatment to AS.



Although patients and urologists generally may prefer similar treatments for PC, they showed different trade-offs between various specific treatment aspects. This implies that urologists need to be aware of potential differences compared with the patient’s perspective on treatment decisions in shared decision making on PC treatment.


prostate cancer treatment; preferences; patients; urologists