title: Effects of prostate cancer screening on health-related quality of life: results of the Finnish arm of the European randomized screening trial (ERSPC).
abstract: BACKGROUND
  As prostate cancer (PC) mortality reduction results are not unequivocal, a special emphasis has to be put on other aspects of the prostate-specific antigen (PSA) screening, including effects on quality of life. In the present study we describe the short-term effects of various phases of PC screening on health-related quality of life (HRQL).
  
  
  METHODS
  The study participants were randomized into the screening arm within the Finnish component of the European Randomized Study on Screening for Prostate Cancer (ERSPC). The RAND 36-Item Health Survey on HRQL and questionnaires on sociodemographic and behavioral factors were delivered to participants at various phases of the first screening round: 1) 500 participants at invitation; 2) 500 after screening; 3) 500 after obtaining the PSA result; 4) to 300 participants after undergoing digital rectal examination (DRE) (but prior to being informed of its result); and 5) approximately 300 after prostate biopsy. At each stage, a new sample of participants was recruited.
  
  
  RESULTS
  Response rates were 59% at invitation, 77% after PSA blood test, 54% after PSA result and 69% after DRE. The men recruited at each stage were comparable in respect to socioeconomic variables. The HRQL scores in RAND-36 subscales showed little variation in the different phases of the screening process. Compared with the previous phase, the social function score was slightly lower after obtaining the PSA result than after blood test, the emotional role score lower after DRE than after PSA result and the pain-related score lower after DRE than after TRUS and biopsy. The screening participants were comparable to the general population as their HRQL scores were similar to an age-stratified general Finnish male population.
  
  
  CONCLUSIONS
  Short-term HRQL effects of prostate cancer screening appear minor and transient.
authors.affiliation: Department of Urology, Helsinki University Central Hospital and University of Helsinki , Helsinki , Finland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Vasarainen
authors.forename: Hanna
authors.initials: H
authors.lastname: Malmi
authors.forename: Liisa
authors.initials: L
authors.lastname: Määttänen
authors.forename: Mirja
authors.initials: M
authors.lastname: Ruutu
authors.forename: Teuvo
authors.initials: T
authors.lastname: Tammela
authors.forename: Kimmo
authors.initials: K
authors.lastname: Taari
authors.forename: Antti
authors.initials: A
authors.lastname: Rannikko
authors.forename: Anssi
authors.initials: A
authors.lastname: Auvinen
mesh_terms: D055088:Early Detection of Cancer; D005387:Finland; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
chemical_list: D017430:Prostate-Specific Antigen