Abstract
BackgroundImplementation of risk-based prostate cancer screening has been proposed as a means to reduce the harms of PSA screening. Little is known, however, about the factors influencing men’s decision to attend a prostate cancer screening based on a risk assessment.MethodWe sent postal invitations with a login to a survey to 10.000 men, three months before invitation to a risk-based prostate cancer screening. Prostate cancer specific worry, prostate cancer-related knowledge, health behaviour, and health related quality of life were used as predictors of subsequent participation. Participation to risk-based prostate cancer screening was defined as providing a blood sample for the STHLM3 trial, a study evaluating a risk-based model that predicts the risk for aggressive prostate cancer.ResultsWith a response rate of 20%, 1.347 men (70%) participated in ensuing risk-based prostate cancer screening three months later whereas 568 men (30%) declined participation in the STHLM3-study. These decliners reported less worry and feeling less vulnerable to prostate cancer and responded “Do not know” more often than participants when asked questions about prostate cancer knowledge. Participants reported greater benefits of prostate testing (p = 0.0005), less barriers to prostate testing (p<0.0001), and higher intention to attend prostate cancer testing (p<0.0001) than decliners. Finally, participants reported better overall health than decliners (p<0.0001).ConclusionProstate cancer worry, PC knowledge, health behaviour and quality of life were identified as predictors of participation in risk-based prostate cancer screening. Targeting these predictors may improve the participation rates. These results can inform policymaking for future population-based prostate cancer screening programs that should address potential worry in men and lack of knowledge about prostate cancer.
Highlights
Prostate cancer (PC) is the second most common cancer in men worldwide [1]
The study was embedded in the STHLM3-study, a population-based diagnostic study of almost 150.000 men aged 50–69 years, investigating whether a panel of biomarkers would more effectively identify men with PC compared with testing with prostate specific antigen (PSA) [6]
The men who later participated in STHLM3 and agreed to undergo PC testing, appeared to report more worry about PC, higher perceived risk of PC, higher levels of HRQoL, and higher intentions to participate in prostate cancer screening (PCS) than those who declined participation Perception of barriers and benefits of PCS differed between the groups The men in both groups had comparable and low levels of knowledge about PC
Summary
Prostate cancer (PC) is the second most common cancer in men worldwide [1]. The harms from testing with prostate specific antigen (PSA) in a screening setting have been judged to outweigh the benefits [3, 4]. PSA-testing has not yet been adopted by any governmental body as a structured and organized population screening method [4]. Implementation of risk-based prostate cancer screening has been proposed as a mean to reduce the harms of PSA screening [5]. Known about the factors influencing men’s decision to attend risk-based prostate cancer screening (PCS). Better understanding of predictors of participation to risk-based PCS is needed to assist in planning for future population based PCS in order to optimize attendance. Predictors of participation in risk-based prostate cancer screening.
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