Psychosocial Issues in Prostate Cancer
Research to date has included survey, focus group, and correlation studies on psychosocial issues related to prostate cancer risk. (Refer to the PDQ summary on Cancer Genetics Risk Assessment and Counseling for more information about psychological issues related to genetic counseling for cancer risk assessment.) Genetic testing for mutations in prostate cancer susceptibility genes, when testing becomes available, has the potential to identify those at highest risk, which facilitates risk-reducing interventions and early detection of prostate cancer. Having an understanding of the motivations of men who may consider genetic testing for inherited susceptibility to prostate cancer will help clinicians and researchers anticipate interest in testing. Further, these data will inform the nature and content of counseling strategies for men and their families, including consideration of the risks, benefits, decision-making issues, and informed consent for genetic testing.
Knowledge about risk of prostate cancer is thought to be a factor influencing men's decisions to pursue prostate cancer screening and, possibly, genetic testing. A study of 79 African American men (38 of whom had been diagnosed with prostate cancer and the remainder who were unaffected but at high risk of prostate cancer) completed a nine-item telephone questionnaire assessing knowledge about hereditary prostate cancer. On a scale of 0 to 9, with 9 representing a perfect score, scores ranged from 3.5 to 9 with a mean score of 6.34. The three questions relating to genetic testing were the questions most likely to be incorrect. In contrast, questions related to inheritance of prostate cancer risk were answered correctly by the majority of subjects. Overall, knowledge of hereditary prostate cancer was low, especially concepts of genetic susceptibility, indicating a need for increased education. An emerging body of literature is now exploring risk perception for prostate cancer among men with and without a family history. Table 10 provides a summary of studies examining prostate cancer risk perception.
Table 10. Summary of Cross-Sectional Studies of Prostate Cancer Risk Perception
|Study Population||Sample Size||Proportion of Study Population That Accurately Reported Their Risk||Other Findings|
|FDR = first-degree relative.|
|Unaffectedmen with a family history of prostate cancer||120 men aged 40–72 y||40%|| |
|FDRof men with prostate cancer||105 men aged 40–70 y||62%|| |
|Men with brothersaffectedwith prostate cancer||111 men aged 33–78 y||Not available||38% of men reported their risk of prostate cancer to be the same or less than the average man.|
|FDR of men with prostate cancer and a community sample||56 men with an FDR with prostate cancer and 100 men without an FDR with prostate cancer all older than 40 y||57%||29% of men with an FDR thought that they were at the same risk as the average man, and 14% believed that they were at somewhat lower risk than average.|