Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Opinion
  • Published:

Psychological aspects of PSA testing

Nature Reviews Urology volume 6, pages 513–515 (2009)Cite this article

Abstract

The process of PSA screening and subsequent monitoring of PSA levels may represent a great source of emotional distress to patients, the majority of whom are not adequately informed about the screening process and the implications of an abnormal result. The need remains for education of patients on the subject, but no consensus has been reached as to the content of information men should be offered. Helping patients to attribute a different meaning to a potentially stressful event can avoid the development of emotional distress, and physicians can have an important role in this process. Informing patients is essential to allow the development of positive coping styles, and establishing good doctor–patient communication leads to improved compliance and the improvement of patients' psychological wellbeing.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Essink-Bot, M. L. et al. Short-term effects of population-based screening for prostate cancer on health-related quality of life. J. Natl Cancer Inst. 90, 925–931 (1998).

    Article  CAS  Google Scholar 

  2. Oliffe, J. Being screened for prostate cancer: a simple blood test or a commitment to treatment? Cancer Nurs. 29, 1–8 (2006).

    Article  Google Scholar 

  3. Schulmann, C. C., Kirby, R. & Fitzpatrick, J. M. Awareness of prostate cancer among the general public: findings of an independent international survey. Eur. Urol. 44, 294–302 (2003).

    Article  Google Scholar 

  4. Hewitson, P. & Austoker, J. Part 2: patient information, informed decision-making and the psycho-social impact of prostate-specific antigen testing. BJU Int. 95 (Suppl. 3), 16–32 (2005).

    Article  Google Scholar 

  5. Chan, E. C. et al., Informed consent for cancer screening with prostate-specific antigen: how well are men getting the message? Am. J. Public Health 93, 779–785 (2003).

    Article  Google Scholar 

  6. Wolf, A. M., Nasser, J. F., Wolf, A. M. & Schorling, J. B. The impact of informed consent on patient interest in prostate-specific antigen screening. Arch. Intern. Med. 156, 1333–1336 (1996).

    Article  CAS  Google Scholar 

  7. Dale, W., Bilir, P., Han, M. & Meltzer, D. The role of anxiety in prostate carcinoma: a structured review of the literature. Cancer 104, 467–478 (2005).

    Article  Google Scholar 

  8. Gattellari, M. & Ward, J. E. Men's reactions to disclosed and undisclosed opportunistic PSA screening for prostate cancer. Med. J. Aust. 182, 386–389 (2005).

    PubMed  Google Scholar 

  9. Gattellari, M. & Ward, J. E. A community study using specified and unspecified scenarios to investigate men's views about PSA screening. Health Expect. 7, 274–289 (2004).

    Article  Google Scholar 

  10. Carlsson, S., Aus, G., Wessman, C. & Hugosson, J. Anxiety associated with prostate cancer screening with special reference to men with a positive screening test (elevated PSA)—results from a prospective, population-based, randomised study. Eur. J. Cancer 43, 2109–2116 (2007).

    Article  Google Scholar 

  11. Brindle, L. A. et al. Measuring the psychosocial impact of population-based prostate-specific antigen testing for prostate cancer in the UK. BJU Int. 93, 777–782 (2006).

    Article  Google Scholar 

  12. Macefield, R. C. et al. Do the risk factors of age, family history of prostate cancer or a higher prostate specific antigen level raise anxiety at prostate biopsy? Eur. J. Cancer doi:10.1016/j.ejca.2009.03.016.

  13. Roth, A. et al. The memorial anxiety scale for prostate cancer: validation of a new scale to measure anxiety in men with prostate cancer. Cancer 97, 2910–2918 (2003).

    Article  Google Scholar 

  14. Roth, A. & Passik, S. Anxiety in men with prostate cancer may interfere with effective management of the disease. Primary Care Cancer 16, 30–37 (1996).

    Google Scholar 

  15. Lofters, A., Juffs, H. G., Pond, G. R. & Tannock, I. F. “PSA-itis”: knowledge of serum prostate specific antigen and other causes of anxiety in men with metastatic prostate cancer. J. Urol. 168, 2516–2520 (2002).

    Article  Google Scholar 

  16. Christie, K. M., Meyerowitz, B. E., Giedzinska-Simons, A., Gross, M. & Agus, D. B. Predictors of affect following treatment decision-making for prostate cancer: conversations, cognitive processing, and coping. Psychooncology 18, 508–514 (2009).

    Article  Google Scholar 

  17. Wilkinson, S., Warren, K., Ramsden, A., Matthews, A. & Chodak, G. Do “rapid” PSA assays reduce anxiety and stress of prostate cancer patients undergoing regular review? A prospective evaluation. Urology 71, 567–572 (2008).

    Article  Google Scholar 

  18. Varetto, A. & Torta, R. La comunicazione e il consenso informato. In Psiconcologia. Il modello biopsicosociale (Eds Torta, R. & Mussa, A.) 89–110 (Centro Scientifico Editore, Torino, 2007).

    Google Scholar 

  19. Costantini, A. et al. Discussion about switch strategy in the adjuvant hormonal therapy of breast cancer: psychological aspects of physician–patient communication. Ann. Oncol. doi:10.1093/annonc/mdp057 (in press).

  20. Ward, J. E., Gupta, L. & Taylor, N. Do general practitioners use prostate-specific antigen as a screening test for early prostate cancer? Med. J. Aust. 169, 29–31 (1998).

    Article  CAS  Google Scholar 

  21. Whitson, J. M. & Konety, B. R. Should men over the age of 65 years receive PSA screening? Argument in favor. Nat. Clin. Pract. Urol. 5, 230–231 (2008).

    Article  Google Scholar 

  22. Albertsen, P. C. Should men over the age of 65 years receive PSA screening? Argument against. Nat. Clin. Pract. Urol. 5, 232–233 (2008).

    Article  Google Scholar 

  23. Gattellari, M. et al. Does 'peer coaching' increase GP capacity to promote informed decision making about PSA screening? A cluster randomised trial. Fam. Pract. 22, 253–265 (2005).

    Article  Google Scholar 

  24. Baile, W. F. et al. SPIKES—a six-step protocol for delivering bad news: application to the patient with cancer. Oncologist 5, 302–311 (2000).

    Article  CAS  Google Scholar 

  25. Back, A. L., Arnold, R. M., Tulsky, J. A., Baile, W. F. & Fryer-Edwards, K. A. Teaching communication skills to medical oncology fellows. J. Clin. Oncol. 21, 2433–2436 (2003).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Clinical and Oncologic Psychology, San Giovanni Battista University Hospital, Turin, Italy

    Riccardo G. V. Torta & Jacopo Munari

Authors
  1. Riccardo G. V. Torta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jacopo Munari
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Riccardo G. V. Torta.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Torta, R., Munari, J. Psychological aspects of PSA testing. Nat Rev Urol 6, 513–515 (2009). https://doi.org/10.1038/nrurol.2009.146

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrurol.2009.146

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing