Objectives
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.
Methods
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.
Results
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).
Conclusions
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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Article info
Publication history
Accepted:
September 28,
2006
Received:
April 26,
2006
Footnotes
This study was funded in part by a Preventive Oncology Academic Award from the National Cancer Institute (K07-CA78540) with supplemental support from the University of Wisconsin Comprehensive Cancer Center.
The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.
Identification
Copyright
© 2007 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
