Abstract
BackgroundProstate cancer (PC) is the most common cancer among men in the western world. Genetic lifetime risk assessment could alleviate controversies about prostate specific antigen (PSA) testing for early diagnosis.AimTo determine how men interpret information about their lifetime risk for PC and how this can affect their choice of having a repeated PSA test.Design & settingA genetic test was offered for assessment of individual PC lifetime risk in general practices in Denmark, with the purpose of promoting appropriate use of PSA testing.MethodParticipants had a genetic lifetime risk assessment for PC diagnosis (either high or normal risk). A month after receiving the result, participants answered a questionnaire about their perceived risk of getting or dying from PC compared with other men, as well as their intentions for repeated PSA testing.ResultsNearly half (44.7%) of 555 participants who received the genetic risk assessment were not aware they had a genetic test. Nevertheless, compared with men with a normal genetic risk, those with high genetic risk reported higher perceived risk for PC (mean difference of 0.74 [95% confidence interval {CI} = 0.56 to 0.96] on a 5-point scale), higher perceived risk of dying from PC (mean difference of 0.48 [95% CI = 0.29 to 0.66] on a 5-point scale), and increased intention for repeated PSA testing (mean difference of 0.48 [95% CI = 0.30 to 0.65] on a 4-point scale).ConclusionDespite low awareness and/or understanding of the test result, a high genetic risk for PC made participants more aware of their risk, and it increased their intention and probability for repeated PSA testing.
Highlights
Prostate cancer (PC) is the most common cancer among men in Europe, with approximately 190 000 new cases and about 80 000 deaths every year.[1,2,3,4] A commonly used method for early detection of PC is the prostate specific antigen (PSA) test, this method has limited accuracy.[5,6] This results in failure to detect genuinely aggressive disease at an early stage, as well as overdiagnosis and overtreatment of indolent cancers that would not give rise to symptoms in the patient’s normal lifespan if left undetected
A month after receiving the result, participants answered a questionnaire about their perceived risk of getting or dying from PC compared with other men, as well as their intentions for repeated PSA testing
A genetic test was offered for assessment of individual PC lifetime risk in Danish general practice, with the purpose of promoting appropriate use of PSA testing
Summary
PC is the most common cancer among men in Europe, with approximately 190 000 new cases and about 80 000 deaths every year.[1,2,3,4] A commonly used method for early detection of PC is the PSA test, this method has limited accuracy.[5,6] This results in failure to detect genuinely aggressive disease at an early stage, as well as overdiagnosis and overtreatment of indolent cancers that would not give rise to symptoms in the patient’s normal lifespan if left undetected. Genetic lifetime risk assessment could alleviate controversies about prostate specific antigen (PSA) testing for early diagnosis
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