Objectives-Widespread implementation of HRQOL measurement in prostate cancer practice and research requires concise instruments. Having 50 questions, the full-length Expanded Prostate cancer Index Composite (EPIC) is cumbersome to administer outside of studies focusing exclusively on HRQOL. To facilitate HRQOL measurement in a broad range of prostate cancer research and practice settings, we developed and validated an abbreviated version of EPIC.Methods-50 questions that comprise the full-length EPIC-50 were evaluated to identify items suitable for elimination while retaining ability to measure the 5 prostate cancer-specific HRQOL domains of EPIC-50. The resulting abbreviated version (EPIC-26) was validated using question responses from 252 subjects who had brachytherapy, external radiotherapy or prostatectomy for prostate cancer. EPIC-26 internal consistency was measured by Cronbach's alpha coefficient and reliability by test-retest correlation.Results-Based on high item-scale correlations, clinically relevant content, and preservation of domain psychometrics, 26 items were retained in EPIC-26 from 50 questions in the full length EPIC-50. High correlation was observed between EPIC-50 and EPIC-26 versions of urinary incontinence, urinary irritation/obstruction, bowel, sexual and vitality/hormonal domain scores (all r ≥0.96). Correlations between different domains were low, confirming that EPIC-26 retains the ability to discern 5 distinct HRQOL domains. Internal consistency and test-retest reliability for EPIC-26 (Cronbach's alpha ≥0.70 and r ≥ 0.69, respectively for all 5 HRQOL domains) support its validity.Conclusions-EPIC-26 is a brief, valid and reliable subjective measure of health quality among prostate cancer patients and suitable for measuring HRQOL among patients undergoing treatment for early stage prostate cancer.

Purpose Measuring prostate cancer patient HRQOL in routine clinical practice is hindered by lack of instruments enabling efficient real-time, point-of-care scoring of multiple HRQOL domains. We sought to develop an instrument for this purpose. Materials and Methods The EPIC for Clinical Practice (EPIC-CP) is a one-page, 16-item questionnaire to measure urinary incontinence, urinary irritation, bowel, sexual, and hormonal HRQOL domains that we constructed by eliminating conceptually overlapping items from the 3 page EPIC-26, and revising the questionnaire format to mirror the AUA Symptom Index, thereby enabling practitioners to calculate HRQOL scores at point of care. We administered EPIC-CP to a new cohort of PCa patients in community-based and academic oncology, radiation, and urology practices to evaluate the instrument’s validity and ease of use for clinical practice. Results 175 treated and 132 untreated PCa subjects completed EPIC-CP (N = 307). EPIC-CP domain scores correlated highly with respective domain scores from longer versions of EPIC (r ≥ 0.93 for all domains). EPIC-CP showed high internal consistency (Cronbach’s α = 0.64-0.84) and sensitivity to PCa treatment-related effects (p < 0.05 in each of 5 HRQOL domains). Patients completed EPIC-CP efficiently (96% in <10 minutes, and 11% missing items). It was deemed ‘very convenient’ by clinicians in 87% of routine clinical encounters, and clinicians accurately scored completed questionnaires 94% of the time. Conclusions EPIC-CP is a valid instrument that enables patient-reported HRQOL to be measured efficiently and accurately at the point of care, and can thereby facilitate improved emphasis and management of patient-reported outcomes.

Our analyses provide no strong evidence of a protective association of fish consumption with prostate cancer incidence but showed a significant 63% reduction in prostate cancer-specific mortality.