• Floyd J Fowler, Michael J Barry, Beth Walker-Corkery, Jean-Francois Caubet, David W Bates, Jeong Min Lee, Alison Hauser, and Mary McNaughton-Collins.
• The General Medicine Division, Massachusetts General Hospital, Boston, MA 02114, USA.
• J Gen Intern Med. 2006 Jul 1; 21 (7): 715721715-21.

ObjectiveTo evaluate the psychological, socio-behavioral, and medical implications of apparently false-positive prostate cancer screening results.MethodsOne hundred and twenty-one men with a benign prostate biopsy performed in response to a suspicious screening test (biopsy group) and 164 men with a normal prostate-specific antigen (PSA) test result (normal PSA group) responded to a questionnaire 6 weeks, 6 and 12 months after their biopsy or PSA test.ResultsThe mean (+/-SD) age of respondents was 61+/-9 years (range, 41 to 88 years). One year later, 26% (32/121) of men in the biopsy group reported having worried "a lot" or "some of the time" that they may develop prostate cancer, compared with 6% (10/164) in the normal PSA group (P<.001). Forty-six percent of the biopsy group reported thinking their wife or significant other was concerned about prostate cancer, versus 14% in the normal PSA group (P<.001). Medical record review showed that biopsied men were more likely than those in the normal PSA group to have had at least 1 follow-up PSA test over the year (73% vs 42%, P<.001), more likely to have had another biopsy (15% vs 1%, P<.001), and more likely to have visited a urologist (71% vs 13%, P<.001).ConclusionOne year later, men who underwent prostate biopsy more often reported worrying about prostate cancer. In addition, there were related psychological, socio-behavioral, and medical care implications. These hidden tolls associated with screening should be considered in the discussion about the benefits and risks of prostate cancer screening.

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