Why men with prostate cancer want wider access to prostate specific antigen testing: qualitative study

Abstract

Objectives To explore the attitudes of men with confirmed or suspected prostate cancer to testing for prostate specific antigen. Design Qualitative interview study with a purposive sample. Setting Great Britain. Participants 52 men with suspected or confirmed prostate cancer, recruited through general practitioners, urologists, patient support groups, and charities. Results Almost all men remembered their prostate specific antigen test but recalled being given little information beforehand. Arguments in favour of increased access to testing included the belief that early diagnosis would reduce mortality, improve quality of life, and save the NHS money. Men also thought that a national screening programme should be available because symptoms can be ambiguous, screening for cancer is responsible health behaviour, and screening would encourage men to be tested. Four men who opposed a screening programme had gathered information alerting them to uncertainty about the benefits of treatment, and two regretted that they had been tested. Others thought that access to testing is restricted in the United Kingdom because of a lack of government backing, concerns about the accuracy of the test, and a lack of resources. Conclusions The few men in this study who subscribed to the argument that evidence of the benefits of treatment is a prerequisite for a screening programme did not want to see screening introduced. Men who proposed an alternative set of principles for testing gave reasons that did not all relate to overoptimism about the benefits of early diagnosis. People who plan services and people who respond to requests for testing need to understand men's perspectives and concerns.

PSA Testing: Are Patients Aware of What Lies Ahead?

“…In a small study in Oxford (n = 52), almost all patients analysed remembered having had a PSA test, but stated that they had received little information at the time of the test. 17 More men in our study reported a lack of awareness in the general practice referred group compared to those men tested in secondary care. In the primary care setting when patients present with LUTS or to request PSA testing, there is often insufficient time to have a lengthy discussion to cover all of the ramifications of PSA testing unless the patient books an appointment specifically for prostate cancer screening.…”

Feasibility of familial PSA screening: psychosocial issues and screening adherence

“…Aspects of masculinity such as appearing weak rather than strong and healthy, may be impacting on participation in screening as shown elsewhere in relation to health practices (Connell, 1995;Moynihan, 1998;Courtenay, 2000), and some of these men may require targeted counselling. The uncertainty surrounding treatment and screening for prostate cancer may have acted as a possible barrier to screening in some men (Chapple et al, 2002).…”

Patient-centred care: What are the experiences of prostate cancer patients and their partners?

“…Previous studies have identified that patients have experienced information deficits at particular times, for example at initial presentation in primary care [10,11,12], for further investigations at hospital [13] and post initial treatment [14,15,16]. This study interviewed patients about their experiences of care to date and the identified information deficits throughout their care pathways.…”