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
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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
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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)