Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Urology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Radiology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
Eur Urol Oncol. 2024 Jun;7(3):553-562. doi: 10.1016/j.euo.2023.11.003. Epub 2023 Nov 22.
A prerequisite before introducing a screening program is that the screening examinations are acceptable to participants.
To evaluate the acceptance and bother of prostate cancer screening examinations.
DESIGN, SETTING, AND PARTICIPANTS: The randomized population-based GÖTEBORG-2 prostate cancer screening trial invited >37 000 men for prostate-specific antigen (PSA) testing followed by magnetic resonance imaging (MRI) in case of elevated PSA and prostate biopsy (targeted and/or systematic) if indicated.
Participants were asked to fill out a questionnaire and rate the level of bother associated with each examination (PSA, MRI, and prostate biopsy) on a categorical scale ranging from 1 to 5 (1 = "not at all bothersome" and 5 = "very bothersome"), and to rate their willingness to repeat the examinations, by marking an X on a continuous scale ranging from 0 to 10 (0 = "yes, without any hesitation" and 10 = "no, absolutely not"). Wilcoxon signed rank test was used.
Compliance with MRI was 96% (1790/1872), compliance with biopsy was 89% (810/907), and the response rate to the questionnaire was 75% (608/810). Men who underwent all examinations (n = 577) responded that biopsy was more bothersome than PSA test (p < 0.001) and MRI (p < 0.001). High levels of bother (≥4 out of 5) were reported by 2% (12/577) for PSA test, 8% (46/577) for MRI, and 43% (247/577) for biopsy. Men were more willing to repeat MRI than biopsy (p < 0.001), but the difference was small (median 0.2 [interquartile range 0.1-0.6] vs 0.5 [0.1-2.0]).
Biopsies are more bothersome than MRI, but a large majority of men accept to repeat both examinations if necessary. Omitting biopsy for MRI-negative men and shifting to targeted biopsies only will reduce bother for men participating in prostate cancer screening.
We asked men how bothersome they found the prostate-specific antigen (PSA) test, magnetic resonance imaging (MRI), and prostate biopsies. Biopsies were more bothersome than PSA and MRI, but most men were willing to repeat all procedures if necessary.
在引入筛查项目之前，一个前提条件是筛查检查要被参与者接受。
评估前列腺癌筛查检查的可接受性和困扰程度。
设计、地点和参与者：随机人群为基础的哥德堡 2 号前列腺癌筛查试验邀请了>37000 名男性进行前列腺特异性抗原（PSA）检测，如果 PSA 升高，则进行磁共振成像（MRI）检查，如果有必要，则进行前列腺活检（靶向和/或系统）。
参与者被要求填写一份问卷，并对每项检查（PSA、MRI 和前列腺活检）相关的困扰程度进行分类评分，范围从 1 到 5（1=“毫不困扰”，5=“非常困扰”），并通过在 0 到 10 的连续量表上标记 X 来表示他们愿意重复这些检查的程度（0=“是，毫不犹豫”，10=“否，绝对不”）。采用 Wilcoxon 符号秩检验。
MRI 的依从率为 96%（1790/1872），活检的依从率为 89%（810/907），问卷的应答率为 75%（608/810）。接受所有检查的男性（n=577）回答说，活检比 PSA 检查（p<0.001）和 MRI（p<0.001）更令人困扰。2%（12/577）的男性报告 PSA 检查有高困扰程度（≥4 分），8%（46/577）的男性报告 MRI 有高困扰程度，43%（247/577）的男性报告活检有高困扰程度。男性更愿意重复 MRI 检查而不是活检（p<0.001），但差异较小（中位数 0.2[四分位距 0.1-0.6]与 0.5[0.1-2.0]）。
活检比 MRI 更令人困扰，但大多数男性如果需要，都愿意重复进行这两项检查。对于 MRI 阴性的男性，省略活检并转为仅进行靶向活检，将减少参与前列腺癌筛查的男性的困扰。
我们询问了男性他们对前列腺特异性抗原（PSA）检测、磁共振成像（MRI）和前列腺活检的困扰程度。活检比 PSA 和 MRI 更令人困扰，但大多数男性如果需要，都愿意重复所有程序。
