Psychological effects of a suspicious prostate cancer screening test followed by a benign biopsy result.
OBJECTIVE
To evaluate the psychological implications of an apparently false-positive screening result for prostate cancer.


METHODS
The sample comprised 167 men with a benign biopsy result in response to a suspicious screening test result (biopsy group) and 233 men with a normal prostate-specific antigen (PSA) test result (control group). The men responded to a questionnaire within about 6 weeks of their biopsy or PSA results. They were asked about demographic characteristics, medical history, psychological effects, biopsy experience, and prostate cancer knowledge.


RESULTS
The survey response rate was 85% (400/471). The mean (+/- SD) age of respondents was 60 +/- 9 years (range, 40 to 88 years); 88% (n = 350) were white. Forty-nine percent (81/167) of men in the biopsy group reported having thought about prostate cancer either "a lot" or "some of the time", compared with 18% (42/230) in the control group (P < 0.001). In addition, 40% (67/167) in the biopsy group reported having worried "a lot" or "some of the time" that they may develop prostate cancer, compared with 8% (18/231) in the control group (P < 0.001).


CONCLUSIONS
Men who underwent prostate biopsy more often reported having thought and worried about prostate cancer, despite having received a benign result. This underrecognized human cost of screening should be considered in the debate about the benefits and harms of prostate cancer screening.
McNaughton-Collins
Mary
M
General Medicine Division, Massachusetts General Hospital, Boston 02114, USA. mmcnaughtoncollins@partners.org
Fowler
Floyd J
FJ
Caubet
Jean-Francois
JF
Bates
David W
DW
Lee
Jeong Min
JM
Hauser
Alison
A
Barry
Michael J
MJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D016009:Chi-Square Distribution; D005189:False Positive Reactions; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000473:pathology / Q000523:psychology*; D011795:Surveys and Questionnaires
D017430:Prostate-Specific Antigen