Prostate-specific antigen testing and prostate biopsy: are self-reported lower urinary tract symptoms and health-related quality of life associated with the decision to undergo these investigations?
Version of Record online: 15 AUG 2008
© 2008 THE AUTHORS. JOURNAL COMPILATION © 2008 BJU INTERNATIONAL
Volume 102, Issue 11, pages 1629–1633, December 2008
How to Cite
Avery, K. N.L., Metcalfe, C., Blazeby, J. M., Lane, J. A., Neal, D. E., Hamdy, F. C. and Donovan, J. L. (2008), Prostate-specific antigen testing and prostate biopsy: are self-reported lower urinary tract symptoms and health-related quality of life associated with the decision to undergo these investigations?. BJU International, 102: 1629–1633. doi: 10.1111/j.1464-410X.2008.07879.x
- Issue online: 21 NOV 2008
- Version of Record online: 15 AUG 2008
- Accepted for publication 30 May 2008
- prostatic neoplasms;
- quality of life;
- urination disorders;
- decision making
To investigate whether men’s self-reported health-related quality of life and lower urinary tract symptoms (LUTS) are associated with acceptance of prostate-specific antigen (PSA) testing and subsequent prostate biopsy.
PATIENTS AND METHODS
In a prospective questionnaire study of men aged 50–69 years, nested within the primary-care-based Prostate testing for cancer and Treatment study in nine UK areas, the Hospital Anxiety and Depression Scale (HADS), 12-item Short Form Health Survey (SF-12) and a self-reported LUTS measure (ICSmaleSF) were completed immediately before having a PSA test or prostate biopsy, or after not responding to an invitation for a PSA test or refusing a biopsy. Analyses compared 348 men accepting or 232 not responding to invitations for PSA testing and 318 accepting or 48 refusing a prostate biopsy.
Men accepting or not responding to the invitation for a PSA test had similar HADS, SF-12 and LUTS scores. Men accepting a biopsy had similar HADS and SF-12 scores to those refusing biopsy, but significantly more LUTS (P < 0.01 for hesitancy, reduced stream, intermittency, incomplete emptying, frequency during the day).
Depressed or anxious mood, comorbidity and LUTS were not associated with the decision to respond to invitations for a PSA test. Men agreeing to a biopsy were more likely to have LUTS than those refusing, suggesting that men believe that LUTS are a symptom of prostate cancer. Men needing a prostate biopsy require more information about LUTS so that they can make informed choices about testing for prostate cancer.