Risk perception, screening practice and interest in genetic testing among unaffected men in families with hereditary prostate cancer

Approximately 5-10% of prostate cancer cases are caused by dominantly inher ited susceptibility to the disease. Although advances have been made in res earch concerning the genetic mechanisms of hereditary prostate cancer, litt le is known about the psychological consequences for men at high risk of de veloping the disease. The aims of the present study were to examine risk pe rception, interest in genetic investigations, cancer-specific worry, and sc reening practice among unaffected men, aged 40-72 years old, with a pedigre e consistent with hereditary prostate cancer and an estimated lifetime risk of prostate cancer of 35-45%. A questionnaire was sent by mail to 120 subj ects, of whom 110 responded. Most of the men (n = 90, 82%) worried about ha ving an inherited susceptibility to prostate cancer, and 34 (31%) claimed t hat worry about prostate cancer affected their daily life (3 (3%) fairly mu ch, 31 (28%) slightly). As many as 40% of the study subjects perceived thei r lifetime risk of prostate cancer as 67% or more. Perceived high risk was associated with symptoms of depression and with cancer worry affecting dail y living. Two-thirds of the men aged 50 years old or more were regularly sc reened for prostate cancer. Subjects with high levels of cancer-specific st ress, as measured by the avoidance subscale of the Impact of Event Scale: w ere less likely to opt for screening. Almost all of the men (94%) were inte rested in presymptomatic genetic testing (84 (76%) "definitely yes" and 20 (18%) ''probably yes''). We conclude that hereditary susceptibility to pros tate cancer has significant psychological consequences although it rarely c auses psychiatric morbidity. The present study underlines the importance of giving thorough, repeated information to men at high risk of prostate canc er. (C) 2000 Elsevier Science Ltd. All rights reserved.