Study Type – Decision analysis (patient preference)
Level of Evidence 4
OBJECTIVE
To evaluate attitudes to prostate cancer screening with prostate‐specific antigen (PSA) of men who complied with offered screening and those who declined it within the Finnish randomized population‐based screening trial, and to compare general health‐related quality of life (HRQL) between participants and non‐participants.
SUBJECTS AND METHODS
Self‐administered questionnaires were sent to 500 men randomized into the screening arm in 1996–99 within the Finnish component of the European Randomized Study on Screening for Prostate Cancer. A similar survey was conducted among 500 non‐participants.
RESULTS
Response proportions among the screening participants and non‐participants were 59% and 28%, respectively. Current smoking was less frequent (P < 0.05) among the participants. In terms of attitude, the participants regarded the prostate cancer study as more important and the invitation letter as more informative than the non‐participants (P < 0.001). There was no clear difference in worry about treatment consequences. The most commonly given reasons for not participating included previous PSA testing (41%), forgetting the invitation (51%), or not wanting to think of prostate cancer (39%) and regarding possible further diagnostic examinations as unpleasant (28%). The non‐participants had a lower mental health score (P < 0.001) than the participants in the RAND‐36 Survey.
CONCLUSION
Most men who chose not to attend screening had a positive attitude, but did not participate due to practical reasons. However, two‐thirds of the non‐participants indicated a willingness to participate in the next screening round.