The psychosocial impact of prostate cancer screening for BRCA1 and BRCA2 carriers.

To report the long-term outcomes from a longitudinal psychosocial study that forms part of the 'Identification of Men with a genetic predisposition to ProstAte Cancer: Targeted Screening in men at higher genetic risk and controls' (IMPACT) study. The IMPACT study is a multi-national study of targeted prostate cancer (PrCa) screening in individuals with a known germline pathogenic variant (GPV) in either the BReast CAncer gene 1 (BRCA1) or the BReast CAncer gene 2 (BRCA2).

Participants enrolled in the IMPACT study were invited to complete a psychosocial questionnaire prior to each annual screening visit for a minimum of 5 years. The questionnaire included questions on sociodemographics and the following measures: Hospital Anxiety and Depression Scale, Impact of Event Scale, 36-item Short-Form Health Survey, Memorial Anxiety Scale for PrCa, Cancer Worry Scale, risk perception and knowledge.

A total of 760 participants completed questionnaires: 207 participants with GPV in BRCA1, 265 with GPV in BRCA2 and 288 controls (non-carriers from families with a known GPV). We found no evidence of clinically concerning levels of general or cancer-specific distress or poor health-related quality of life in the cohort as a whole. Individuals in the control group had significantly less worry about PrCa compared with the carriers; however, all mean scores were low and within reported general population norms, where available. BRCA2 carriers with previously high prostate-specific antigen (PSA) levels experience a small but significant increase in PrCa anxiety (P = 0.01) and PSA-specific anxiety (P < 0.001). Cancer risk perceptions reflected information provided during genetic counselling and participants had good levels of knowledge, although this declined over time.

This is the first study to report the longitudinal psychosocial impact of a targeted PrCa screening programme for BRCA1 and BRCA2 carriers. The results reassure that an annual PSA-based screening programme does not have an adverse impact on psychosocial health or health-related quality of life in these higher-risk individuals. These results are important as more PrCa screening is targeted to higher-risk groups.

BJU international. 2024 Jun 05 [Epub ahead of print]

Elizabeth K Bancroft, Elizabeth C Page, Mark N Brook, Jennifer Pope, Sarah Thomas, Kathryn Myhill, Brian T Helfand, Pooja Talaty, Kai-Ren Ong, Emma Douglas, Jackie Cook, Derek J Rosario, Monica Salinas, Saundra S Buys, Jo Anson, Rosemarie Davidson, Mark Longmuir, Lucy Side, Diana M Eccles, Marc Tischkowitz, Amy Taylor, Mara Cruellas, Eduard Perez Ballestero, Ruth Cleaver, Mohini Varughese, Julian Barwell, Mandy LeButt, Lynn Greenhalgh, Rachel Hart, Ashraf Azzabi, Irene Jobson, Lynn Cogley, D Gareth Evans, Jeanette Rothwell, Natalie Taylor, Matthew Hogben, Sibel Saya, IMPACT Study Steering Committee; IMPACT Collaborators , Rosalind A Eeles, Neil K Aaronson

Oncogenetics Team, Royal Marsden NHS Foundation Trust, London, UK., Oncogenetics Team, Institute of Cancer Research, London, UK., Division of Urology, John and Carol Walter Center for Urological Health, NorthShore University HealthSystem, Evanston, IL, USA., West Midlands Regional Clinical Genetics Service, Birmingham Women's Hospital, Birmingham, UK., Sheffield Clinical Genetics Service, Sheffield Children's Hospital, Sheffield, UK., Royal Hallamshire Hospital, Sheffield, UK., Hereditary Cancer Program, ICO (Catalan Institute of Oncology), Barcelona, Spain., Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA., West of Scotland Genetic Service, Queen Elizabeth University Hospital, Glasgow, UK., Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK., East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Trust, Cambridge, UK., Hereditary Cancer Genetics Group, Medical Oncology Department, Hospital Vall d'Hebron, Vall d'Hebron Institute of Oncology, Barcelona, Spain., Peninsula Clinical Genetics Service, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK., University of Leicester, Leicester, UK., University Hospitals Leicester, Leicester, UK., Liverpool Centre for Genomic Medicine, Liverpool Women's NHS Foundation Trust, Liverpool, UK., Northern Centre for Cancer Care, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK., Peninsular Genetics, Derriford Hospital, Plymouth, UK., Genomic Medicine, Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust, Manchester, UK., Netherlands Cancer Institute, Amsterdam, Netherlands.