Risk perception and psychological morbidity in men at elevated risk for prostate cancer

Area of Science:

• Urology
• Oncology
• Psychology

Background:

• Prostate-specific antigen (PSA) screening increases detection of high-risk prostate conditions, including elevated PSA and high-grade intraepithelial neoplasia (HGPIN).
• Assessing the psychological impact and risk perception in men with these precursor conditions is crucial for patient care.

Purpose of the Study:

• To evaluate and compare psychological well-being and risk perception between patients diagnosed with early-stage prostate cancer (PCa) and those identified as high-risk for PCa.
• To understand the psychological burden associated with PCa diagnosis versus high-risk indicators.

Main Methods:

• A cohort of 168 early-stage localized PCa patients and 69 high-risk individuals (16 HGPIN, 53 elevated PSA) completed surveys on psychological symptoms, risk aversion, and cancer-specific risk perception.
• Analysis of variance (ANOVA) was employed to compare psychological well-being and risk appraisal between the PCa and high-risk groups.

Main Results:

• The high-risk group reported a significantly lower perception of dying from causes other than PCa compared to the PCa group (p = 0.007).
• Patients diagnosed with PCa exhibited significantly more clinically relevant psychological symptoms than the high-risk group.

Conclusions:

• Identifying prostate conditions predictive of cancer progression may not elicit the same psychological distress as a PCa diagnosis, but can distort perceived mortality risk.
• While PCa patients experience diminished psychological well-being, they possess a clearer understanding of recurrence and mortality risks.
• Educational interventions regarding PCa risks and outcomes can mitigate anxiety and worry in at-risk men undergoing health assessments.