The psychosocial impact of prostate cancer screening for BRCA1 and BRCA2 carriers.
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Bancroft Elizabeth K, Page Elizabeth C, Brook Mark N, Pope Jennifer, Thomas Sarah, Myhill Kathryn, Helfand Brian T, Talaty Pooja, Ong Kai-Ren, Douglas Emma, Cook Jackie, Rosario Derek J, Salinas Monica, Buys Saundra S, Anson Jo, Davidson Rosemarie, Longmuir Mark, Side Lucy, Eccles Diana M, Tischkowitz Marc, Taylor Amy, Cruellas Mara, Ballestero Eduard Perez, Cleaver Ruth, Varughese Mohini, Barwell Julian, LeButt Mandy, Greenhalgh Lynn, Hart Rachel, Azzabi Ashraf, Jobson Irene, Cogley Lynn, Evans D Gareth, Rothwell Jeanette, Taylor Natalie, Hogben Matthew, Saya Sibel, IMPACT Study Steering Committee; IMPACT Collaborators, Eeles Rosalind A, Aaronson Neil K
Аннотация
SUBJECTS AND METHODS: Participants enrolled in the IMPACT study were invited to complete a psychosocial questionnaire prior to each annual screening visit for a minimum of 5 years. The questionnaire included questions on sociodemographics and the following measures: Hospital Anxiety and Depression Scale, Impact of Event Scale, 36-item Short-Form Health Survey, Memorial Anxiety Scale for PrCa, Cancer Worry Scale, risk perception and knowledge.
RESULTS: A total of 760 participants completed questionnaires: 207 participants with GPV in BRCA1, 265 with GPV in BRCA2 and 288 controls (non-carriers from families with a known GPV). We found no evidence of clinically concerning levels of general or cancer-specific distress or poor health-related quality of life in the cohort as a whole. Individuals in the control group had significantly less worry about PrCa compared with the carriers; however, all mean scores were low and within reported general population norms, where available. BRCA2 carriers with previously high prostate-specific antigen (PSA) levels experience a small but significant increase in PrCa anxiety (P = 0.01) and PSA-specific anxiety (P < 0.001). Cancer risk perceptions reflected information provided during genetic counselling and participants had good levels of knowledge, although this declined over time.
CONCLUSION: This is the first study to report the longitudinal psychosocial impact of a targeted PrCa screening programme for BRCA1 and BRCA2 carriers. The results reassure that an annual PSA-based screening programme does not have an adverse impact on psychosocial health or health-related quality of life in these higher-risk individuals. These results are important as more PrCa screening is targeted to higher-risk groups.