Experiences of Uncertainty in Men With an Elevated PSA

Area of Science:

• Urology
• Oncology
• Health Communication

Background:

• Prostate-specific antigen (PSA) testing is common for prostate cancer (PCa) screening in men aged 50-70.
• A high percentage (approx. 70%) of men with elevated PSA levels do not receive a PCa diagnosis, leading to potential uncertainty.

Purpose of the Study:

• To explore the experiences of men with elevated PSA levels who were not diagnosed with PCa.
• To understand the sources and impact of uncertainty in this patient group.
• To identify factors influencing uncertainty management.

Main Methods:

• Conducted semistructured interviews with 13 men who had elevated PSA levels but no PCa diagnosis.
• Analyzed interview data to identify themes related to uncertainty and coping strategies.

Main Results:

• Uncertainty was a prominent reaction, driven by unanswered questions about PSA tests, PCa risk, and management plans.
• Patient-provider communication quality (empathetic, lay language, opportunity for questions) significantly influenced uncertainty levels.
• Men employed information seeking, healthcare seeking, self-monitoring, and defensive cognition to manage uncertainty.

Conclusions:

• Effective physician communication is crucial for addressing patient informational needs and reducing uncertainty after an elevated PSA test.
• Strategies should focus on improving communication clarity, empathy, and patient engagement to manage post-test uncertainty in prostate cancer screening.