Psychological benefits of prostate cancer screening: The role of reassurance

Objectives: The role of reassurance in decision-making about screening for health problems is largely unknown. We examined the reassurance value of prostate cancer screening in primary care patients. Setting and participants: One hundred and sixty eight men, aged 45-70 years, who had no history of prostate cancer, from three family medicine practices in southeast Texas. Methods: A hypothetical scenario was developed where men were asked to assume they did not have prostate cancer, and then to rank three predefined screening states with regard to reassurance value: (A) unknown (no screening), (B) normal by screening [a prostate-specific antigen (PSA) test and a digital rectal examination (DRE)] and (C) normal by biopsy (abnormal PSA test and DRE results but a negative ultrasound-guided prostate biopsy). Results: Most of the men (96.8%) associated some reassurance value with screening, considering health state A to be the worst possible health state. Results from a multivariate analysis showed that preference for screening state C was associated with a family history of prostate cancer and perceived greater risk for prostate cancer compared with other men. Conclusion: These findings suggest that prostate cancer screening may have some reassurance value for men, and that increased risk status may explain why some men prefer the added reassurance afforded by screening.