Levels of anxiety were assessed through questionnaires completed by 1781 screen-positive (PSA > or = 3 ng/mL) men attending the European Randomised Study of Screening for Prostate Cancer in Gothenburg, Sweden. During the first visit (clinical examination, including biopsies), no anxiety whilst awaiting the PSA test results was reported by 66% and 2% reported high levels of anxiety. A multinomial logistics model for repeated measurements, adjusted for age, PSA level, heredity, biopsy finding and urinary symptoms, revealed that anxiety awaiting the PSA was only influenced (increased) by the existence of previously elevated PSA tests (p<.0001). No anxiety associated with biopsy was reported by 45%, while 6% experienced high levels of anxiety. Levels of anxiety decreased significantly with subsequent rounds of examinations (p<0.0001) and with increasing age (p=0.0016). Anxiety associated with prostate cancer screening in general is low to moderate, even in men with elevated PSA, and severe anxiety affects a smaller group of susceptible men.