Decision-making about PSA testing and prostate biopsies: a qualitative study embedded in a primary care randomised trial.
OBJECTIVE
The overall aim was to increase understanding of men's decision-making about prostate-specific antigen (PSA) testing and subsequent biopsy.


METHODS
This qualitative interview study was nested within the primary care-based Prostate Testing for Cancer and Treatment (ProtecT) trial in nine United Kingdom areas (ISRCTN number: 20141297). Fifty-eight men aged 50-69 yr (mean: 62 yr), accepting (n=14) or not responding (n=7) to invitations for PSA testing and accepting (n=24) or refusing (n=13) prostate biopsy were interviewed.


RESULTS
In this study, men accepting PSA testing and biopsy reported positively on their experiences, regardless of the final outcome. PSA testing was considered routine and biopsy acceptable to most men. Men both responding and not responding to PSA testing often perceived themselves to be at low risk for prostate cancer. Men refusing biopsy also tended to perceive themselves to be at low risk and many were anxious about the test itself. Misunderstandings about the relationship between urinary symptoms and risk of prostate cancer were identified.


CONCLUSIONS
Most men found PSA testing and biopsy acceptable, but perceptions of risk were not always accurate and the provision of more tailored information may help facilitate informed decision-making.
Avery
Kerry N L
KN
Department of Social Medicine, University of Bristol, Bristol, United Kingdom. kerry.avery@bristol.ac.uk <kerry.avery@bristol.ac.uk>
Blazeby
Jane M
JM
Lane
J Athene
JA
Neal
David E
DE
Hamdy
Freddie C
FC
Donovan
Jenny L
JL
D000368:Aged; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology*; D016032:Randomized Controlled Trials as Topic
D017430:Prostate-Specific Antigen