False-positive PSA results lead to excess worry, sexual dysfunction

Men with prostate cancer screenings that result in false-positive results are approximately three times as likely to indicate some degree of concern about developing prostate cancer, and are nearly twice as likely to experience impaired sexual function, compared with men with normal results, new research from the University of Iowa, Iowa City, shows.

The authors of for the study, which appeared in Urology (2007; 69:215-20), surveyed 210 men: 101 men with normal PSA levels and 109 men with abnormal PSA readings or abnormal digital rectal exams but biopsies that were negative for prostate cancer. Based on a 5-point “worry” scale, patients with abnormal PSA/DRE results were more worried about getting prostate cancer than were those patients with normal test results (p=.0001). In addition, about twice as many men in the abnormal results group reported that sexual function was a moderate to big problem (19% vs. 10%, p=.0001).

“Because screening affects a large number of men relative to those who are expected to benefit from treatment, even a small adverse effect of apparently false-positive results on cancer-related worry and quality of life could have a substantial impact on public health,” said lead author David Katz, MD.

Sexual function-related issues reported by men with false positives may be a residual impact of the biopsy, which can cause initial pain, or it may be directly correlated with worry about the possibility of having cancer, Dr. Katz noted. He said the finding requires further investigation.