A cohort study reporting clinical risk factors and individual risk perceptions of prostate cancer: implications for PSA testing

OBJECTIVES: To determine men's perceptions of their risk of developing prostate cancer.• To consider the implications for PSA testing based on individual risk perceptions. PATIENTS AND METHODS: The research adopted an embedded mixed-method design, using clinical records and a retrospective postal survey.• Patients (N= 474) diagnosed with prostate cancer in a two-year period (2008–2009) in Greater Glasgow were identified from pathology records.• In all, 458 men received a postal survey (16 deceased patients were excluded); 320 men responded (70%). RESULTS: Analysis indicates that there is no association between known clinical risk factors and men's perceptions of their own risk.• Older men did not display increased perceived risk. Men with a family history of prostate cancer (11%) had no increase in their own perception of risk.• PSA tests are not requested by those who are at greater risk.• The subsample of patients who had requested a test were no more likely to have a family history of prostate cancer. They were more likely, however, to perceive themselves to be at high risk, to have friends with prostate cancer, to be affluent and to have a low grade tumour. CONCLUSIONS:GPs need to balance men's risk perceptions in discussions about known clinical risk factors.• Men's knowledge of prostate cancer stems largely from interpersonal sources (such as friends/family).• Social networks may consequently offer an additional opportunity to increase awareness of risk-stratified testing