Psychological effects of a suspicious prostate cancer screening test followed by a benign biopsy result

Am J Med. 2004 Nov 15;117(10):719-25. doi: 10.1016/j.amjmed.2004.06.036.


Purpose: To evaluate the psychological implications of an apparently false-positive screening result for prostate cancer.

Methods: The 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.

Results: The 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).

Conclusion: Men 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Chi-Square Distribution
  • False Positive Reactions
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / psychology*
  • Surveys and Questionnaires


  • Prostate-Specific Antigen