Prostate cancer has three known clinical risk factors: age, ethnicity and family history. Men's knowledge of prostate cancer is low.
This study demonstrates that men rely on family and friends to learn about prostate cancer and help them interpret their risk. The findings suggest the need for tailored prostate cancer education, through social networks, to encourage risk-stratified PSA testing, which will lead to earlier diagnosis for those most at risk.

Objectives

To determine men's perceptions of their risk of developing prostate cancer.
To consider the implications for PSA testing based on individual risk perceptions.

Patients and Methods

The research adopted an embedded mixed-method design, using clinical records and a retrospective postal survey.
Patients (N = 474) diagnosed with prostate cancer in a two-year period (2008–2009) in Greater Glasgow were identified from pathology records.
In all, 458 men received a postal survey (16 deceased patients were excluded); 320 men responded (70%).

Results

Analysis indicates that there is no association between known clinical risk factors and men's perceptions of their own risk.
Older men did not display increased perceived risk. Men with a family history of prostate cancer (11%) had no increase in their own perception of risk.
PSA tests are not requested by those who are at greater risk.
The subsample of patients who had requested a test were no more likely to have a family history of prostate cancer. They were more likely, however, to perceive themselves to be at high risk, to have friends with prostate cancer, to be affluent and to have a low grade tumour.

Conclusions

GPs need to balance men's risk perceptions in discussions about known clinical risk factors.
Men's knowledge of prostate cancer stems largely from interpersonal sources (such as friends/family).
Social networks may consequently offer an additional opportunity to increase awareness of risk-stratified testing.

References

1 Aus G, Abbou CC, Bolla M et al. EAU guidelines on prostate cancer. Eur Urol 2005; 48: 546–551
10.1016/j.eururo.2005.06.001
CASPubMedWeb of Science®Google Scholar
2 Xu J, Kibel AS, Hu JJ. Prostate cancer risk associated loci in African Americans. Cancer Epidemiol Biomarkers Prev 2009 18: 2145–2149
10.1158/1055-9965.EPI-09-0091
CASPubMedWeb of Science®Google Scholar
3 Johns LE, Houlston RS. A systematic review and meta-analysis of familial prostate cancer risk. BJU Int 2003 91: 789–794
10.1046/j.1464-410X.2003.04232.x
CASPubMedWeb of Science®Google Scholar
4 Steele CB, Miller DS, Maylahn C, Uhler RJ, Baker CT. Knowledge, attitudes, and screening practices among older men regarding prostate cancer. Am J Public Health 2000; 90: 1595–1600
10.2105/AJPH.90.10.1595
CASPubMedWeb of Science®Google Scholar
5 Fitzpatrick JM, Kirby RS, Brough CL, Saggerson AL. Awareness of prostate cancer among patients and the general public: results of an international survey. Prostate Cancer Prostatic Dis 2009; 12: 347–354
10.1038/pcan.2009.30
CASPubMedWeb of Science®Google Scholar
6 Fitzpatrick P, Corcoran N, Fitzpatrick JM. Prostate cancer: how aware is the public? Br J Urol 1998; 82: 43–48
10.1046/j.1464-410x.1998.00685.x
CASPubMedWeb of Science®Google Scholar
7 Jacobsen PB, Lamonde LA, Honour M, Kash K, Hudson PB, Pow-Sang J. Relation of family history of prostate cancer to perceived vulnerability and screening behavior. Psychooncology 2004; 13: 80–85
10.1002/pon.760
PubMedWeb of Science®Google Scholar
8 Bratt O, Damber JE, Emanuelsson M et al. Risk perception, screening practice and interest in genetic testing among unaffected men in families with hereditary prostate cancer. Eur J Cancer 2000 36: 235–241
10.1016/S0959-8049(99)00272-5
CASPubMedWeb of Science®Google Scholar
9 Bloom JR, Stewart SL, Oakley-Girvans I, Banks PJ, Chang SB. Family history, perceived risk, and prostate cancer screening among African American men. Cancer Epidemiol Biomarkers Prev 2006 15: 2167–2173
10.1158/1055-9965.EPI-05-0738
PubMedWeb of Science®Google Scholar
10 Montgomery GH, Erblich J, DiLorenzo T, Bovbjerg DH. Family and friends with disease: their impact on perceived risk. Prev Med 2003; 37: 242–249
10.1016/S0091-7435(03)00120-8
PubMedWeb of Science®Google Scholar
11 de Nooijer J, Lechner L, de Vries H. A qualitative study on detecting cancer symptoms and seeking medical help; an application of Andersen's model of total patient delay. Patient Educ Couns 2001 42: 145–157
10.1016/S0738-3991(00)00104-X
PubMedWeb of Science®Google Scholar
12 Smith LK, Pope C, Botha JL. Patients’ help-seeking experiences and delay in cancer presentation: a qualitative synthesis. Lancet 2005; 366: 825–831
10.1016/S0140-6736(05)67030-4
PubMedWeb of Science®Google Scholar
13 Andriole GL. Editorial: screening for prostate cancer. BMJ 2010; 341: c4538
Google Scholar
14 Stavridis S, Saidi S, Lekovski LJ, Dohcev S, Spasovski G. Screening for prostate cancer: a controversy or fact. Hippokratia 2010 14: 170–175
CASPubMedWeb of Science®Google Scholar
15 Stark JR, Mucci L, Rothman KJ, Adami HO. Screening for prostate cancer remains controversial. BMJ 2009; 339: b3601
10.1136/bmj.b3601
PubMedWeb of Science®Google Scholar
16 Barry MJ. Screening for prostate cancer – the controversy that refuses to die. N Engl J Med 2009; 360: 1351–1354
10.1056/NEJMe0901166
CASPubMedWeb of Science®Google Scholar
17 Bangmaa CH, van Schaikb RH, Blijenbergb BG, Roobola MJ, Liljac H, Stenmand U. On the use of prostate-specific antigen for screening of prostate cancer in European Randomised Study for Screening of Prostate Cancer. Eur J Cancer 2011; 46: 3109–3119
10.1016/j.ejca.2010.09.031
Web of Science®Google Scholar
18 Creswell JW, Plano Clark VL. Designing and Conducting Mixed Methods Research. London: Sage, 2006
Google Scholar
19 James ND, Sydes MR, Clarke NW et al. Systemic therapy for advancing or metastatic prostate cancer (STAMPEDE): a multi-arm, multistage randomized controlled trial. BJU Int 2009 103: 464–469
10.1111/j.1464-410X.2008.08034.x
CASPubMedWeb of Science®Google Scholar
20 Macleod U, Mitchell ED, Burgess C, Macdonald S, Ramirez AJ. Risk factors for delayed presentation and referral of symptomatic cancer: evidence for common cancers. Br J Cancer 2009 101: 92–101
10.1038/sj.bjc.6605398
PubMedWeb of Science®Google Scholar
21 Young JM, Muscatello DJ, Ward JE. Are men with lower urinary tract symptoms at increased risk of prostate cancer? A systematic review and critique of the available evidence. BJU Int 2000 85: 1037–1048
10.1046/j.1464-410x.2000.00659.x
CASPubMedWeb of Science®Google Scholar
22 Lane JA, Hamdy FC, Martin RM, Neal DE, Donovan JL. Latest results from the UK trials evaluating prostate cancer screening and treatment: the CAP and ProtecT studies. Eur J Cancer 2010; 46: 3095–3101
10.1016/j.ejca.2010.09.016
CASPubMedWeb of Science®Google Scholar
23 Andriole GL, Grubb RL, Buys SS et al. Mortality results from a randomized prostate-cancer screening trial. N Engl J Med 2009; 360: 1310–1319
10.1056/NEJMoa0810696
CASPubMedWeb of Science®Google Scholar
24 Walsh D, Bendel N, Jones R, Hanlon P. Investigating A ‘Glasgow Effect’. Glasgow: Glasgow Centre for Population Health, 2010
Google Scholar
25 Alexander AS, Mydin A, Jones SO et al. Extreme-risk prostate adenocarcinoma presenting with prostate-specific antigen (PSA) >40 ng/ml: prognostic significance of the preradiation PSA nadir. Int J Radiat Oncol Biol Phys 2011; 81: e713–719
10.1016/j.ijrobp.2010.11.068
PubMedWeb of Science®Google Scholar
26 Schroder FH. Screening for prostate cancer (PC) – an update on recent findings of the European Randomized Study of Screening for Prostate Cancer (ERSPC). Urol Oncol 2008 26: 533–541
10.1016/j.urolonc.2008.03.011
PubMedWeb of Science®Google Scholar
27 Dobson R. More evidence suggests that PSA testing leads to ‘overdiagnosis’ of cancer. BMJ 2006; 22: 166
10.1136/bmj.333.7560.166-a
Google Scholar
28 Pashayan N, Powles J, Brown C, Duffy SW. Excess cases of prostate cancer and estimated over diagnosis associated with PSA testing in East Anglia. Br J Cancer 2006; 95: 401–405
10.1038/sj.bjc.6603246
CASPubMedGoogle Scholar

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Volume111, Issue3

March 2013

Pages 389-395

A cohort study reporting clinical risk factors and individual risk perceptions of prostate cancer: implications for PSA testing

Abstract

What's known on the subject? and What does the study add?

Objectives

Patients and Methods

Results

Conclusions

References

Citing Literature

References

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A cohort study reporting clinical risk factors and individual risk perceptions of prostate cancer: implications for PSA testing

Abstract

What's known on the subject? and What does the study add?

Objectives

Patients and Methods

Results

Conclusions

References

Citing Literature

References

Related

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