"It's a maybe test": men's experiences of prostate specific antigen testing in primary care.

Abstract

BACKGROUND: Prostate specific antigen (PSA) testing in primary care is an important and contentious issue. Due to concerns about the test and the value of early detection, countries such as the UK advocate 'informed choice' instead of population screening. It is not known whether this policy is actually adhered to in primary care. Furthermore, little is known of the experiences of men who face this decision. AIM: To explore the experiences, understanding, and views of men who considered or undertook PSA testing in UK primary care. DESIGN OF STUDY: Qualitative interview-based study. SETTING: Primary care, Wales, UK. METHOD: Semi-structured one-to-one interviews were conducted with 28 men, representing a range of clinical outcomes. Transcripts were coded and subjected to thematic analysis. RESULTS: Three themes were identified: the decision-making context, the locus of decision making, and uncertainty related to the PSA test. CONCLUSION: The decision to undertake PSA testing was affected by both social and media factors and it did not appear to be a patient-led decision. The decision created considerable uncertainty for men and this uncertainty persisted after the test, even if the result was normal. Raised PSA led to further investigations and this exacerbated the uncertainty. Anxiety and regret were consequences of this uncertainty.