Prostate screening can induce psychological stress even after negative biopsy
MedWire News: Researchers have urged doctors to warn men of the potential psychological distress caused by prostate-specific antigen (PSA) testing and prostate biopsies during screening for prostate cancer.
In a study involving 330 UK men with a negative biopsy result, the majority were not greatly stressed by the overall screening experience, but 10% of men did report clinically significant stress levels 12 weeks after their biopsy.
“It’s essential that doctors know about this, and that men are fully informed of the psychological challenges they may face during and after a PSA test,” said lead author Kavita Vedhara (University of Nottingham, UK)
While not routinely offered in the UK, “PSA testing in asymptomatic men continues to rise,” explain Vedhara and colleagues in the British Journal of Cancer.
Distress levels and negative moods were evaluated using the Profile of Mood States-short form (POMS) and the Impact of Events Scale (IES) when the men attended the PSA test, the biopsy, within a few days of receiving their negative biopsy result, and again approximately 12 weeks later.
The researchers report low overall distress scores relative to clinically significant thresholds, despite a significant 9.47 difference in IES score at the time of biopsy compared with scores at the time of PSA testing. Furthermore, almost 20% of the examined men experienced high levels of tension–anxiety (19.4% out of 180) and psychological distress (19.3% out of 171) at the time of biopsy.
In addition, the percentage of men with a clinically concerning distress level at the time of biopsy decreased only slightly on learning their negative result, from 19.3% to 16.9%. After 12 weeks, 9.7% of men were still distinctly distressed by the screening process.
In contrast, reports of depression–dejection (7.5%), anger–hostility (6.8%), fatigue–inertia (12%), and confusion–bewilderment (8.3%) in the POMS questionnaire were highest at the time of the PSA test, but 12 weeks after the negative biopsy, less than 5% of men reported any of these symptoms.
“These results, particularly that high levels of distress may be encountered by some men, should be included in information presented to men by general practitioners before they consent to receiving a test,” suggest Vedhara et al.
Commenting on the results, Martin Ledwick from the charity Cancer Research UK, said: “This study shows just how important it is that men in their 50s and 60s can talk to their doctor about the pros and cons of having a PSA test.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010
By Sarah Guy