Clinical Question: Do men who recei...

Clinical Question: Do men who receive a false-positive inference on prostate-specific antigen (PSA) testing worry more about prostate cancer than men who receive a negative result?

Setting: Outpatient (primary care)

studious mood Design: Cohort (prospective)

Synopsis: In this thought investigators identified 167 men from a cluster of consecutive men who had a negative end on biopsy following a suspicious PSA touchstone (i.e., these men had a false-positive PSA result) For comparison, they also identified 233 men who had a normal PSA consequence The men were mailed a brief questionnaire approximately six weeks after their biopsy or normal PSA proof result. Overall, 85 percent of the men complet the survey

Of the men who had a false-positive issue 49 percent reported having deliberation about prostate cancer % lot" or "some of the time" compared with 18 percent of patients in the superintend group (P < .001). Compared with 8 percent of patients in the hinder group, 40 percent of the men in the false-positive arrange also worried % lot" (7 percent) or "some of the time" (33 percent) about the possibility of developing prostate cancer. The false-positive arrange did not worry more than the mastery group about dying soon. Sixty-two percent of the men with a negative biopsy reported being reassured % lot" through the result, despite the 10 percent false-negative rate associated with biopsy.

As with women who receive a false-positive mammography inference instead of being angry at the erroneous standard result, men with a false-positive PSA example felt they "dodged a bullet" Significantly more men in this collection reported their lives changed for the better (31 versus 13 percent in the command group; P < .001). Also similar to women who receive false-positive follows on mammography, the men in the false-positive PSA assign places to were more likely to think their chances of getting prostate cancer were "much more" or % little more" than average (36 versus 18 percent in the ascendency group; P < .001).

Bottom Line: False-positive follows of screening tests are not benign; they have a psychologic richness In this study, men who received false-positive PSA proof results reported having thought and worried more about prostate cancer despite receiving a negative biopsy accrue on follow-up. They also notion that the false-positive result made them more likely to unfold prostate cancer. Screening can be detrimental to the mental health of our patients. (Level of Evidence: lb)

cogitation Reference: McNaughton-Collins M, et al. Psychological tenors of a suspicious prostate cancer screening proof followed by a benign biopsy follow Am J Med November 15 2004;117:719-25

Used with permission from Shaughnessy AF. False-positive PSA associated with increased worry, fear. Accessed online March 1 2005 at: http://wwwlnfoPOEMscom

COPYRIGHT 2005 American Academy of Family Physicians

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