Perceptions about screening for prostate cancer using genetic lifetime risk assessment: a qualitative study

Area of Science:

• Urology
• Oncology
• Public Health

Background:

• Health authorities advise against prostate cancer screening (PSA tests) for asymptomatic, low-risk individuals due to overdiagnosis/overtreatment risks.
• Opportunistic prostate cancer screening remains prevalent in primary care, highlighting a need for improved risk assessment tools.
• This study explored patient perceptions of prostate cancer risk and opportunistic screening following initial PSA testing and genetic risk assessment.

Purpose of the Study:

• To investigate patient perceptions of prostate cancer risk.
• To understand patient attitudes towards opportunistic prostate cancer screening.
• To assess the influence of PSA tests and genetic risk assessments on screening intentions.

Main Methods:

• Semi-structured patient interviews were conducted.
• Interviews were recorded and transcribed verbatim.
• Thematic analysis was used to analyze the collected data.

Main Results:

• Patients perceived prostate cancer as an unavoidable risk with age, emphasizing immediate testing benefits over potential overtreatment.
• Frustration was expressed regarding conflicting public health messages on early cancer detection versus refraining from opportunistic screening.
• Despite a normal PSA test and low genetic lifetime risk, patients maintained a high perception of personal prostate cancer risk.

Conclusions:

• Patients perceive high prostate cancer risk, valuing early detection through PSA testing.
• Conflicting public health advice on screening benefits versus overdiagnosis risks causes patient frustration.
• Genetic risk assessments did not significantly alter patients' intentions for future PSA testing.