[Perceived autonomy of long-term prostate cancer survivors]

Autonomy is a fundamental psychological need in old age. It is closely linked to quality of life, psychological well-being, and functional capacity. In long-term prostate cancer (PCa) survivors, autonomy may be compromised by age- and treatment-related factors.

To assess perceived autonomy in long-term PCa survivors and identify sociodemographic, clinical, and psychosocial predictors.

Cross-sectional analysis of data from the German multicentre project "Familial Prostate Cancer". A total of 2143 long-term PCa (mean age: 80 years) survivors after radical prostatectomy were included. Perceived autonomy was assessed using an item from the "Perceived Autonomy in Old Age Scale" and dichotomized into "rather autonomous" vs. "rather not autonomous". Sociodemographic, clinical, and psychosocial factors were analysed.

Overall, 86% of participants perceived themselves as "rather autonomous". Lower perceived autonomy was significantly associated with higher age, lower education, poorer perceived economic situation, current PCa therapy, reduced quality of life, lower subjective well-being, fear of progression, and lack of daily internet use (all p < 0.001).

Although perceived autonomy remains high in many older PCa survivors, it is vulnerable and related to modifiable factors. Findings highlight key targets for a patient-centered, autonomy-supportive approach in long-term uro-oncologic survivorship care.