Investigating men's perceived lifetime risk of prostate cancer.
Survey-based study to men invited for prostate-specific antigen (PSA) screening in the GÖTEBORG-2 trial between September 2015 and June 2020.
38 775 men in the Gothenburg area, Sweden, were invited for PSA-testing and participated in a survey.
17 980 men participated in PSA-testing, of whom 13 189 completed the survey. In addition, 1264 men answered the survey only.
Before having the PSA-test, men answered an electronic survey and estimated their lifetime risk of receiving a prostate cancer diagnosis on a visual analogue scale from 0% to 100%.
The primary outcome was the median lifetime risk estimation, which was compared with Wilcoxon test to an anticipated lifetime risk of 20% (based on GÖTEBORG-1 trial). The secondary outcome was to determine factors associated with risk estimation in a multivariable linear regression model: previous prostate examination, family history, physical exercise, healthy diet, comorbidity, alcohol consumption, smoking, education level, marital status, urinary symptoms and erectile dysfunction.
Among PSA-tested men, the median estimated lifetime risk of prostate cancer was 30% (IQR 19% to 50%), corresponding to a 10 percentage-points higher estimation compared with the anticipated risk (p<0.001). Family history of prostate cancer, moderate to severe urinary symptoms and mild to moderate erectile dysfunction were associated with >5 percentage-points higher risk estimation. Similar results were obtained for non-PSA-tested men.
Most men overestimated their prostate cancer risk which underscores the importance of providing them accurate information about prostate cancer.
ISRCTN94604465.
BMJ open. 2024 Aug 17*** epublish ***
Emmeli Palmstedt, Marianne Månsson, Karin Stinesen Kollberg, Sigrid Carlsson, Mikael Hellström, Jonas Wallström, Jonas Hugosson, Rebecka Arnsrud Godtman
Department of Urology, University of Gothenburg Institute of Clinical Sciences, Goteborg, Sweden ., Department of Urology, University of Gothenburg Institute of Clinical Sciences, Goteborg, Sweden., Department of Surgery and Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York City, New York, USA., Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden.