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Measuring the psychosocial impact of population-based prostate-specific antigen testing for prostate cancer in the UK

Measuring the psychosocial impact of population-based prostate-specific antigen testing for prostate cancer in the UK
Measuring the psychosocial impact of population-based prostate-specific antigen testing for prostate cancer in the UK
OBJECTIVE To evaluate the psychosocial impact of participation in a population-based prostate-specific antigen (PSA) testing programme, akin to screening, and to explore the relationship between urinary symptoms reported before PSA testing and the response to the subsequent PSA result.
PATIENTS AND METHODS This prospective questionnaire study was nested within the case-finding component of the ProtecT (prostate testing for cancer and treatment) feasibility study (ISRCTN20141297). Men aged 50–69 years from 18 general practices in three cities in the UK completed the Hospital Anxiety and Depression Scale (HADS), the Short Form-12 (SF-12) Health Survey, and the International Continence Society 'male' (ICSmale) questionnaires before giving consent for a PSA test in a community clinic (baseline). Men with an 'abnormal' PSA result returned for further investigation (including biopsy) and repeated these questionnaires before biopsy.
RESULTS At baseline, study participants had similar levels of anxiety and depression to the general male population. There was no increase in the HADS scores, or reduction in the SF-12 mental health component summary score, on attendance at the biopsy clinic after receiving an 'abnormal' PSA result. Urinary symptoms were associated with levels of anxiety and depression before receiving a PSA result (baseline), but were not associated with anxiety and depression at biopsy independently of baseline scores. Therefore changes in anxiety or depression at biopsy did not appear to differ between those with and without urinary symptoms.
CONCLUSIONS This study confirms the findings of other studies that the deleterious effects of receiving an abnormal PSA result during population screening are not identified by generic health-status questionnaires. Comparisons with outcomes of studies measuring cancer-specific distress and using qualitative research methods raise the question of whether a prostate cancer screening-specific instrument is required. However, a standardized measure of anxiety identified differences at baseline between those who did and did not report urinary symptoms. These findings suggest that it might be advisable to better inform men undergoing PSA testing about the uncertain relationship between urinary symptoms and prostate cancer, to minimize baseline levels of psychological distress.
prostate cancer, PSA test, screening, psycho-social impact, urinary symptoms
1464-4096
777-782
Brindle, L.A.
17158264-2a99-4786-afc0-30990240436c
Oliver, S.E.
9d5a45c1-b868-4eb6-957e-26670bd689c8
Dedman, D.
55e1b8be-bf85-466c-b220-9e96d5bfd3a8
Donovan, J.L.
49ade379-60a2-489e-a99a-bf8259401256
Neal, D.E.
a5e5e0db-db06-4451-84e0-1ef19fd49c5d
Hamdy, F.C.
c34edec8-e653-40e7-a4f1-c12fa159ab49
Lane, J.A.
b9ec44ab-b42b-4499-9258-2b0b7ab510df
Peters, T.J.
d0f06d2a-9c79-4fdb-a528-e13007c25df2
Brindle, L.A.
17158264-2a99-4786-afc0-30990240436c
Oliver, S.E.
9d5a45c1-b868-4eb6-957e-26670bd689c8
Dedman, D.
55e1b8be-bf85-466c-b220-9e96d5bfd3a8
Donovan, J.L.
49ade379-60a2-489e-a99a-bf8259401256
Neal, D.E.
a5e5e0db-db06-4451-84e0-1ef19fd49c5d
Hamdy, F.C.
c34edec8-e653-40e7-a4f1-c12fa159ab49
Lane, J.A.
b9ec44ab-b42b-4499-9258-2b0b7ab510df
Peters, T.J.
d0f06d2a-9c79-4fdb-a528-e13007c25df2

Brindle, L.A., Oliver, S.E., Dedman, D., Donovan, J.L., Neal, D.E., Hamdy, F.C., Lane, J.A. and Peters, T.J. (2006) Measuring the psychosocial impact of population-based prostate-specific antigen testing for prostate cancer in the UK. BJU International, 98 (4), 777-782. (doi:10.1111/j.1464-410X.2006.06401.x).

Record type: Article

Abstract

OBJECTIVE To evaluate the psychosocial impact of participation in a population-based prostate-specific antigen (PSA) testing programme, akin to screening, and to explore the relationship between urinary symptoms reported before PSA testing and the response to the subsequent PSA result.
PATIENTS AND METHODS This prospective questionnaire study was nested within the case-finding component of the ProtecT (prostate testing for cancer and treatment) feasibility study (ISRCTN20141297). Men aged 50–69 years from 18 general practices in three cities in the UK completed the Hospital Anxiety and Depression Scale (HADS), the Short Form-12 (SF-12) Health Survey, and the International Continence Society 'male' (ICSmale) questionnaires before giving consent for a PSA test in a community clinic (baseline). Men with an 'abnormal' PSA result returned for further investigation (including biopsy) and repeated these questionnaires before biopsy.
RESULTS At baseline, study participants had similar levels of anxiety and depression to the general male population. There was no increase in the HADS scores, or reduction in the SF-12 mental health component summary score, on attendance at the biopsy clinic after receiving an 'abnormal' PSA result. Urinary symptoms were associated with levels of anxiety and depression before receiving a PSA result (baseline), but were not associated with anxiety and depression at biopsy independently of baseline scores. Therefore changes in anxiety or depression at biopsy did not appear to differ between those with and without urinary symptoms.
CONCLUSIONS This study confirms the findings of other studies that the deleterious effects of receiving an abnormal PSA result during population screening are not identified by generic health-status questionnaires. Comparisons with outcomes of studies measuring cancer-specific distress and using qualitative research methods raise the question of whether a prostate cancer screening-specific instrument is required. However, a standardized measure of anxiety identified differences at baseline between those who did and did not report urinary symptoms. These findings suggest that it might be advisable to better inform men undergoing PSA testing about the uncertain relationship between urinary symptoms and prostate cancer, to minimize baseline levels of psychological distress.

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More information

Published date: October 2006
Keywords: prostate cancer, PSA test, screening, psycho-social impact, urinary symptoms

Identifiers

Local EPrints ID: 41444
URI: http://eprints.soton.ac.uk/id/eprint/41444
ISSN: 1464-4096
PURE UUID: 90b15df9-f9a3-4110-86a7-320e5919ca3e
ORCID for L.A. Brindle: ORCID iD orcid.org/0000-0002-8933-3754

Catalogue record

Date deposited: 08 Sep 2006
Last modified: 03 Dec 2019 01:46

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