PSYCHOLOGICAL REACTIONS IN MEN SCREENED FOR PROSTATE-CANCER

被引:74
作者
GUSTAFSSON, O
THEORELL, T
NORMING, U
PERSKI, A
OHSTROM, M
NYMAN, CR
机构
[1] KAROLINSKA HOSP,DEPT OCCUPAT MED,STOCKHOLM,SWEDEN
[2] NATL INST PSYCHOSOCIAL FACTORS & HLTH,STOCKHOLM,SWEDEN
来源
BRITISH JOURNAL OF UROLOGY | 1995年 / 75卷 / 05期
关键词
SCREENING; PROSTATE CANCER; STRESS; PSYCHOLOGICAL REACTION;
D O I
10.1111/j.1464-410X.1995.tb07422.x
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objective To investigate the possible negative psychological impact of screening for prostate cancer with special focus on the impact of false positive and true positive test results. Subjects and methods As part of an early detection study for prostate cancer psychological and psychophysiological reactions to various phases of the diagnostic procedures were examined in 2400 randomly selected men divided into various groups. Their psychophysiological reactions were assessed by measurements of serum cortisol and their psychological reactions by questionnaires directed at determining emotional states and sleep disturbance. In a stratified sample of the population (100 men) measurements were made at the time of the screening examination and again 2 weeks later. In patients undergoing biopsy (307 men) measurements were made 2 weeks after screening, but before they were informed of the biopsy results, and again 4 and 16 weeks after screening. Results Serum cortisol levels at the screening examination were higher than corresponding levels of a comparable sample of Swedish men during normal daily activity, indicating that an invitation to examination for prostate cancer per se might create emotional stress. Two weeks after the screening the elevated levels had decreased to normal. The highest cortisol levels were found in men who had undergone biopsy, immediately before they were informed of the results 2 weeks after screening. After they were informed, cortisol levels fell, regardless of the results of the biopsy. The patterns of emotional state and sleep disturbance were similar except that sleep disturbance was delayed. Conclusion In screening programmes for prostate cancer it is important to define clearly the high-risk groups to minimize the risk of adverse psychological reactions in those subjects with a low risk of having the disease. The results also emphasize the need to reduce the number of false positive results by choosing diagnostic tests of high specificity. The interval between a test and informing the subject of the results should be minimized to decrease the duration of the increased emotional stress.
引用
收藏
页码:631 / 636
页数:6
相关论文
共 28 条
[1]   MEASUREMENT OF FEELINGS USING VISUAL ANALOGUE SCALES [J].
AITKEN, RCB .
PROCEEDINGS OF THE ROYAL SOCIETY OF MEDICINE-LONDON, 1969, 62 (10) :989-+
[2]   EXPERIMENTAL CHANGES IN SHIFT SCHEDULES - THEIR EFFECTS ON WELL-BEING [J].
AKERSTEDT, T ;
TORSVALL, L .
ERGONOMICS, 1978, 21 (10) :849-856
[3]  
BERNEFROMELL K, 1982, THESIS LINKOPING U L
[4]   PSYCHOLOGICAL REACTIONS IN PUBLIC MELANOMA SCREENING [J].
BRANDBERG, Y ;
BOLUND, C ;
MICHELSON, H ;
MANSSONBRAHME, E ;
RINGBORG, U ;
SJODEN, PO .
EUROPEAN JOURNAL OF CANCER, 1993, 29A (06) :860-863
[5]   SCREENING FOR PROSTATIC-CARCINOMA WITH PROSTATE SPECIFIC ANTIGEN [J].
BRAWER, MK ;
CHETNER, MP ;
BEATIE, J ;
BUCHNER, DM ;
VESSELLA, RL ;
LANGE, PH .
JOURNAL OF UROLOGY, 1992, 147 (03) :841-845
[6]  
BULL AR, 1991, BRIT J RADIOL, V64, P540
[7]  
CATALONA WJ, 1991, NEW ENGL J MED, V317, P1156
[8]   PROSTATE-CANCER DETECTION IN A CLINICAL UROLOGICAL PRACTICE BY ULTRASONOGRAPHY, DIGITAL RECTAL EXAMINATION AND PROSTATE SPECIFIC ANTIGEN [J].
COONER, WH ;
MOSLEY, BR ;
RUTHERFORD, CL ;
BEARD, JH ;
POND, HS ;
TERRY, WJ ;
IGEL, TC ;
KIDD, DD .
JOURNAL OF UROLOGY, 1990, 143 (06) :1146-1154
[9]   PSYCHIATRIC MORBIDITY AFTER SCREENING FOR BREAST-CANCER [J].
DEAN, C ;
ROBERTS, MM ;
FRENCH, K ;
ROBINSON, S .
JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, 1986, 40 (01) :71-75
[10]  
DENIS LJ, 1992, PROSTATE S, V4, P63