Journal Article

How a population-based cohort of men estimate lifetime risk of prostate cancer in a survey before entering a prostate cancer screening trial in Sweden?

Arnsrud Godtman, Rebecka, Kollberg, Karin Stinesen, Palmstedt, Emmeli, Månsson, Marianne, Carlsson, Sigrid, Wallström, Jonas, Hugosson, Jonas, Hellström, Mikael

2024

Overview

ObjectivesInvestigating men’s perceived lifetime risk of prostate cancer.DesignSurvey-based study to men invited for prostate-specific antigen (PSA) screening in the GÖTEBORG-2 trial between September 2015 and June 2020.Setting38 775 men in the Gothenburg area, Sweden, were invited for PSA-testing and participated in a survey.Participants17 980 men participated in PSA-testing, of whom 13 189 completed the survey. In addition, 1264 men answered the survey only.InterventionsBefore 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%.Main outcome measuresThe 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.ResultsAmong 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.ConclusionsMost men overestimated their prostate cancer risk which underscores the importance of providing them accurate information about prostate cancer.Trial registration numberISRCTN94604465.

• Publisher: British Medical Journal Publishing Group,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Aged / Alcohol / Angina pectoris / Antigens / blood / Chronic obstructive pulmonary disease / Clinical Medicine / Comorbidity / diagnosis / Early Detection of Cancer / epidemiology / Erectile dysfunction / Exercise / Family medical history / Humans / Klinisk medicin / Male / Medical and Health Sciences / Medical diagnosis / Medical screening / Medicin och hälsovetenskap / methods / Middle Aged / Original Research / Population / prostate / Prostate cancer / Prostate-Specific Antigen / Prostate-Specific Antigen - blood / Prostatic Neoplasms / Prostatic Neoplasms - diagnosis / Prostatic Neoplasms - epidemiology / Risk Assessment / Risk Assessment - methods / Risk Factors / Surveys and Questionnaires / Sweden / Sweden - epidemiology / Urologi / urological tumours / Urology