Do men regret prostate biopsy: Results from the PiCTure study

BMC Urology, Jan 2017

Background Understanding men’s experience of prostate biopsy is important as the procedure is common, invasive and carries potential risks. The psychological aspects of prostate biopsy have been somewhat neglected. The aim of this study was to explore the level of regret experienced by men after prostate biopsy and identify any associated factors. Methods Men attending four clinics in Republic of Ireland and two in Northern Ireland were given a questionnaire to explore their experience of prostate biopsy. Regret was measured on a Likert scale asking men how much they agreed with the statement “It [the biopsy] is something I regret.” Results Three hundred thirty-five men responded to the survey. The mean age was 63 years (SD ±7 years). Three quarters of respondents (76%) were married or co-habiting, and (75%) finished education at primary or secondary school level. For just over two thirds of men (70%) their recent biopsy represented their first ever prostate biopsy. Approximately one third of men reported a diagnosis of cancer, one third a negative biopsy result, and the remaining third did not know their result. Two thirds of men reported intermediate or high health anxiety. 5.1% of men agreed or strongly agreed that they regretted the biopsy. Conclusions Level of regret was low overall. Health anxiety was the only significant predictor of regret, with men with higher anxiety reporting higher levels of regret than men with low anxiety (OR = 3.04, 95% CI 1.58, 5.84). Men with high health anxiety may especially benefit from careful counselling before and after prostate biopsy.

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Do men regret prostate biopsy: Results from the PiCTure study

Coyle et al. BMC Urology Do men regret prostate biopsy: Results from the PiCTure study Catherine Coyle 2 Eileen Morgan 1 Frances J. Drummond 0 4 Linda Sharp 0 3 Anna Gavin 1 0 National Cancer Registry Ireland , Cork , Ireland 1 Northern Ireland Cancer Registry, Queen's University , Belfast , Northern Ireland 2 Public Health Agency , Belfast , Northern Ireland 3 Institute of Health & Society, Newcastle University , Newcastle , UK 4 Department of Epidemiology and Public Health, University College Cork , Cork , Ireland Background: Understanding men's experience of prostate biopsy is important as the procedure is common, invasive and carries potential risks. The psychological aspects of prostate biopsy have been somewhat neglected. The aim of this study was to explore the level of regret experienced by men after prostate biopsy and identify any associated factors. Methods: Men attending four clinics in Republic of Ireland and two in Northern Ireland were given a questionnaire to explore their experience of prostate biopsy. Regret was measured on a Likert scale asking men how much they agreed with the statement “It [the biopsy] is something I regret.” Results: Three hundred thirty-five men responded to the survey. The mean age was 63 years (SD ±7 years). Three quarters of respondents (76%) were married or co-habiting, and (75%) finished education at primary or secondary school level. For just over two thirds of men (70%) their recent biopsy represented their first ever prostate biopsy. Approximately one third of men reported a diagnosis of cancer, one third a negative biopsy result, and the remaining third did not know their result. Two thirds of men reported intermediate or high health anxiety. 5.1% of men agreed or strongly agreed that they regretted the biopsy. Conclusions: Level of regret was low overall. Health anxiety was the only significant predictor of regret, with men with higher anxiety reporting higher levels of regret than men with low anxiety (OR = 3.04, 95% CI 1.58, 5.84). Men with high health anxiety may especially benefit from careful counselling before and after prostate biopsy. Prostate; Biopsy; Regret - Background Prostate biopsy is an invasive test that involves rectal insertion of an ultrasound probe to diagnose cancer of the prostate. It is usually prompted by a raised Prostate Specific Antigen (PSA), prostatic symptoms, an abnormal digital rectal examination (DRE) or a combination of these. The incidence of prostate cancer has until recently increased in most developed countries [1] and has the potential to increase further in future decades [2]. While acknowledging that predictions can be uncertain and that the ongoing debate about the benefits of screening for prostate cancer may also affect incidence, given population growth and the growing proportion of older people in the population, it is possible that the absolute number of biopsies will increase further. Prostate biopsy * Correspondence: †Equal contributors 1Public Health Agency, Belfast, Northern Ireland Full list of author information is available at the end of the article can be difficult for men to tolerate, and commonly results in physical side effects [3, 4] including bleeding, pain, urinary retention and infection. While the physical side effects have been well investigated, the psychological impact of prostate biopsy has been somewhat neglected [5, 6]. Decision-related regret is a negative emotion associated with thinking about a choice one has made or is about to make [7]. Evidence has grown which shows that men who choose different treatment options for prostate cancer report differing levels of regret, and the factors which predict regret have become a focus of investigation [8]. Previous studies of men with prostate cancer suggest that the demographic factors of: older age [8], being single [8–10] and lower educational attainment [10, 11] were associated with higher levels of treatment regret. Clinically, those experiencing treatment-related complications/side effects [8], with better pre-operative © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. erectile function, post-operative incontinence, longer time from surgery to survey [8], and trait anxiety [9], were associated with higher levels of treatment regret. Decisional regret with respect to prostate biopsy does not appear to have been investigated. The aim of this study was to investigate, for the first time, (...truncated)


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Catherine Coyle, Eileen Morgan, Frances Drummond, Linda Sharp, Anna Gavin. Do men regret prostate biopsy: Results from the PiCTure study, BMC Urology, 2017, pp. 11, 17, DOI: 10.1186/s12894-016-0194-y