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Health Perceptions in Patients Who Undergo Screening and Workup for Prostate Cancer
Journal article   Open access   Peer reviewed

Health Perceptions in Patients Who Undergo Screening and Workup for Prostate Cancer

David A Katz, David F Jarrard, Colleen A McHorney, Stephen L Hillis, Donald A Wiebe and Dennis G Fryback
Urology (Ridgewood, N.J.), Vol.69(2), pp.215-220
2007
DOI: 10.1016/j.urology.2006.09.059
PMCID: PMC1868466
PMID: 17320653
url
https://doi.org/10.1016/j.urology.2006.09.059View
Published (Version of record) Open Access

Abstract

False-positive screening tests may induce persistent psychological distress. This study was designed to determine whether a positive screening test with negative biopsy findings for prostate cancer is associated with worsened mental health during short-term follow-up. We conducted a cross-sectional telephone survey of two groups of men approximately 2 months after testing: group 1, 109 men with an abnormal prostate-specific antigen level or digital rectal examination findings but with negative biopsy findings for prostate cancer; and group 2, 101 age-matched primary care patients with PSA screening levels in the reference range (less than 4 ng/mL). Primary outcomes included state anxiety and prostate cancer-related worry. Secondary outcomes included Medical Outcomes Study Short Form 36-item Health Survey subscales and sexual function items. Multivariate regression techniques were used to adjust for differences in baseline covariates. Group 1 patients were more worried than group 2 patients about getting prostate cancer (mean worry 3.9 versus 4.5, P = 0.0001, using a 5-point scale, with 1 indicating extreme worry and 5 no worry). Group 1 patients also perceived their risk of prostate cancer to be significantly greater than that of controls ( P = 0.001). No significant differences were found across state anxiety or Medical Outcomes Study Short Form 36-item Health Survey subscales. Sexual bother was greater for group 1 patients, with 19% reporting that sexual function was a moderate to big problem compared with 10% of group 2 patients ( P = 0.0001). Men with abnormal prostate cancer screening tests report increased cancer-related worry and more problems with sexual function, despite having a negative biopsy result. Effective counseling interventions are needed before prostate cancer screening and during follow-up.

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