Taylor K L, DiPlacido J, Redd W H, Faccenda K, Greer L, Perlmutter A
Department of Psychiatry, Georgetown University Medical Center, Washington, DC 20007, USA.
Cancer. 1999 Mar 15;85(6):1305-12. doi: 10.1002/(sici)1097-0142(19990315)85:6<1305::aid-cncr13>3.0.co;2-i.
The goals of this study were to 1) understand the reasons that men seek prostate carcinoma screening, in light of the ongoing medical controversy surrounding screening; and 2) assess the level of psychological distress and perceived risk among men seeking screening, and whether or not these variables were dependent on a man's family history of prostate carcinoma.
The subjects were 126 men (40% had a family history of prostate carcinoma) who participated in a free prostate carcinoma detection program. Questionnaires, which were completed prior to prostate carcinoma screening, included demographic and medical information, reasons for screening participation, general and cancer-related psychological distress, and perceived risk for prostate carcinoma.
Among both family history groups, self-referral was the most common reason for attending the screening, compared with receiving a recommendation from a health professional or from a friend or family member. Men with a positive family history were not more distressed than those without a family history; but as the authors predicted, men with a positive family history of prostate carcinoma did report higher levels of perceived risk relative to those without a family history. In addition, an interaction revealed that psychological distress was greater among men with a family history only among those who also reported elevated perceived risk.
Similar to other prostate carcinoma screening programs, men in the current sample largely elected to attend the screening on their own. Furthermore, although perceived risk was higher among men with a family history compared with those without a family history, psychological distress was greater among men with a family history only among those who also reported elevated perceived risk. Thus, among men with a family history of the disease, perceived risk may be a marker of elevated psychological distress. Screening programs should assess family history and perceived risk because of the potential psychological implications for screening participants.
鉴于围绕前列腺癌筛查存在的医学争议，本研究的目的是：1）了解男性寻求前列腺癌筛查的原因；2）评估寻求筛查的男性的心理困扰程度和感知风险水平，以及这些变量是否取决于男性的前列腺癌家族史。
研究对象为126名男性（40%有前列腺癌家族史），他们参加了一个免费的前列腺癌检测项目。在进行前列腺癌筛查之前完成的问卷包括人口统计学和医学信息、参与筛查的原因、一般和与癌症相关的心理困扰以及前列腺癌的感知风险。
在两个家族史组中，与从健康专业人员或朋友或家庭成员那里获得建议相比，自我推荐是参加筛查最常见的原因。有家族史的男性并不比没有家族史的男性更困扰；但正如作者所预测的，有前列腺癌家族史阳性的男性相对于没有家族史的男性确实报告了更高水平的感知风险。此外，一项交互作用显示，只有在那些也报告感知风险升高的有家族史的男性中，心理困扰才更大。
与其他前列腺癌筛查项目类似，当前样本中的男性大多选择自行参加筛查。此外，尽管有家族史的男性比没有家族史的男性感知风险更高，但只有在那些也报告感知风险升高的有家族史的男性中，心理困扰才更大。因此，在有该疾病家族史的男性中，感知风险可能是心理困扰加剧的一个标志。由于对筛查参与者可能产生心理影响，筛查项目应该评估家族史和感知风险。
