• Mary McNaughton-Collins, Floyd J Fowler, Jean-Francois Caubet, David W Bates, Jeong Min Lee, Alison Hauser, and Michael J Barry.
• General Medicine Division, Massachusetts General Hospital, Boston 02114, USA. mmcnaughtoncollins@partners.org
• Am. J. Med. 2004 Nov 15; 117 (10): 719725719-25.

PurposeTo evaluate the psychological implications of an apparently false-positive screening result for prostate cancer.MethodsThe sample comprised 167 men with a benign biopsy result in response to a suspicious screening test result (biopsy group) and 233 men with a normal prostate-specific antigen (PSA) test result (control group). The men responded to a questionnaire within about 6 weeks of their biopsy or PSA results. They were asked about demographic characteristics, medical history, psychological effects, biopsy experience, and prostate cancer knowledge.ResultsThe survey response rate was 85% (400/471). The mean (+/- SD) age of respondents was 60 +/- 9 years (range, 40 to 88 years); 88% (n = 350) were white. Forty-nine percent (81/167) of men in the biopsy group reported having thought about prostate cancer either "a lot" or "some of the time", compared with 18% (42/230) in the control group (P < 0.001). In addition, 40% (67/167) in the biopsy group reported having worried "a lot" or "some of the time" that they may develop prostate cancer, compared with 8% (18/231) in the control group (P < 0.001).ConclusionMen who underwent prostate biopsy more often reported having thought and worried about prostate cancer, despite having received a benign result. This underrecognized human cost of screening should be considered in the debate about the benefits and harms of prostate cancer screening.

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