Patients' anxieties and fears: a comparison between transrectal prostate biopsy and prostate MRI

Prostate biopsies are an invasive procedure that can lead to anxieties and fear before the examination. Prostate magnetic resonance imaging (MRI) is seen as a non-invasive test although it is known that "scanxiety" affects many patients. Transrectal ultrasound (TRUS)-guided prostate biopsies and multiparametric prostate MRI (mpMRI) are commonly used methods in patients with suspected prostate cancer (PCa). This study investigates fears and anxieties towards the TRUS and mpMRI.

All patients scheduled for mpMRI or TRUS biopsy between January and December 2018 were asked to participate in this single-center study. A total of 196 completed questionnaires were returned and included.

On a 5-point Likert scale the fear of the examination was lower for the mpMRI [1.53; 95% confidence interval (CI): 1.38 to 1.69] than for a TRUS biopsy (2.47; 95% CI: 2.21 to 2.71). In detail, patients with a scheduled TRUS biopsy had significantly higher levels for fear of pain [2.49 (95% CI: 2.19 to 2.78) vs. 1.51 (95% CI: 1.35 to 1.67); P<0.001] and fear of complications [2.71 (95% CI: 2.45 to 2.98) vs. 2.11 (95% CI: 1.89 to 2.32); P=0.001]. There was no relevant difference about the fact that patients knew what to expect [3.02 (95% CI: 2.68 to 3.35) vs. 2.99 (95% CI: 2.70 to 3.26); P=0.47] and the expectation that the examination will go over well [3.24 (95% CI: 2.92 to 3.57) vs. 3.27 (95% CI: 3.00 to 3.58); P=0.55].

On average, fear levels were moderate before mpMRI and TRUS biopsy. Patients are more afraid of TRUS biopsy than mpMRI but the differences were low. The biggest fear remains the fear of the result of the examinations independently of the method.