Barriers to prostate cancer screening: psychological aspects and descriptive variables---is there a correlation?

OBJECTIVE: To evaluate psychological and demographic aspects of men who received DRE during the PCa screening in an outpatient clinical setting.

METHODS: Patients (345) who underwent DRE for the first time from February 2006 to December 2007 were evaluated for their psychological reactions and feelings after the examination.

RESULTS: The average age of the patients was 52.8 years (25 - 85 years); 40.94% had felt fear (examination fear 15.94%, and diagnosis fear 25%), 26.45% shame and 48.26% indicated they were not thinking about anything. There was no correlation between age, educational level and emotional reactions. Most patients (96.8%) would undergo a DRE again and 52.35% had considered it better than they had imagined. Of these patients, 41.81% were illiterate/incomplete elementary school. Only 4.12% described having a negative experience. The factors that persuaded the patients to book an appointment were: 50.1% made their own decision, 26.67% were recommended by a physician, 18.55% family/friends and 6.67% were influenced by the media. Wives booked 24.06% of the consultations. Although 85.47% of patients had some previous knowledge about the examination, 80.81% felt they had further clarification afterward. Lower educational level was related to lack of information about DRE, while 52.38% who made their own decision had previous knowledge of the importance of DRE.

CONCLUSION: The majority of the patients found DRE less awkward than they had imagined it to be and would repeat the examination in the future. Fear and shame before the examination are present and are barriers to the DRE.