Worry about prostate cancer and risk perception among middle-aged men - results from the PROBASE trial

Aug 30, 2026

Cancer worry and risk perception are key psychological determinants of preventive health behavior, making their drivers essential to clarify. This community-based study in 45-year-old men within the German PROBASE prostate cancer screening trial evaluated the prevalence and correlates of worry about prostate cancer and absolute versus comparative risk perception using self-report questionnaires and clinical interviews. Multivariable logistic regression used 33,476 participants. Findings link prostate-related worry and risk perception to LUTS and positive family history.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages14

Reading Time35 min

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Abstract

Introduction

Worry about prostate cancer and risk perception among middle-aged men: results from the PROBASE trial Valentin H. Meissner1 · Andreas Dinkel2 · Martina Kron3 · Stefan Schiele1 · Matthias Jahnen1 · Jale Lakes4 · Jan Philipp Radtke4 · Markus A. Kuczyk5 · Nina N. Harke5 · Jürgen Debus6 · Christoph A. Fink6 · Gerald Antoch7 · Lars Schimmöller7 · Glen Kristiansen8 · Agne Krilaviciute9 · Petra Seibold9 · Sabine Behrens10 · Axel Benner11 · Christian Arsov4 · Boris Hadaschik12 · Nikolaus Becker9 · Rudolf Kaaks10 · Peter Albers4,9 · Jürgen E. Gschwend1 · Kathleen Herkommer1 Received: 20 July 2024 / Accepted: 8 February 2025 / Published online: 5 March 2025 © The Author(s) 2025 Abstract Cancer worry and risk perception are relevant psychological factors that influence preventive health behaviors. Therefore, a thorough understanding of the factors that impact their occurrence and manifestation is critical. The objective of this study was to assess prevalence and factors associated with worry about prostate cancer (PCa) and absolute/comparative risk perception in a community-based sample of 45-year-old men. Data were collected within the German PCa screening trial PROBASE. Variables were assessed by self-report questionnaires and a clinical interview. Worry about PCa and absolute/comparative risk perception were assessed each on a 5-point-Likert scale. Multivariable logistic regression was used to identify factors associated with the outcomes of interest. Data were available for 33,476 (72.0%) of 46,495 men at enrollment. 7.3% had sometimes/(very) often worry about PCa. 3.7% and 9.9% perceived their absolute risk and comparative risk as somewhat high/very high and somewhat higher/much higher, respectively. 18.8% reported a positive PCa family history. Important factors of worry about PCa, absolute risk perception, and comparative risk perception were lower urinary tract symptoms (LUTS) (OR 3.00, 95% CI 2.63–3.42; OR 2.09, CI 1.71–2.56; OR 2.41, CI 2.10–2.76) anda positive PCa family history (OR 2.35, CI 2.08–2.65; OR 15.13, CI 12.73–17.97; OR 9.69, CI 8.76–10.72) . A positive history of urological (OR 3.85, CI 2.63–5.63) and non-urological cancers (OR 1.97, CI 1.52–2.54) were associated with a higher comparative risk perception. In conclusion, worry about PCa and risk perception are influenced by non-cancerrelated symptoms as well as by a positive PCa family history. These findings need to be addressed in risk communication with patients. Keywords Absolute risk perception · Cancer worry · Comparative risk perception · Family history · Lower urinary tract symptoms · Prostate cancer Introduction Prostate cancer (PCa) is the second most common cancer in men worldwide (Bray et al., 2018) and most often diagnosed following an elevated prostate-specific antigen (PSA) level (Cooperberg et al., 2005) . However, there is uncertainty about the benefits of PCa screening due to an elevated risk of overdiagnosis (Brawley, 2012) . Patients and their health care providers must weigh benefits, uncertainties, and risks of PCa screening resulting in a complex Extended author information available on the last page of the article decision-making. Additionally, conflicting recommendations across various health authorities (Grossman et al., 2018; Mottet et al., 2017) increase this complexity and men with a family history of PCa must be aware of their elevated risk in their decision-making process. For instance, risk perceptions play an important role in many theories on health behavior including the Protection Motivation Theory (Rogers, 1975) and the Health Belief Model (Rosenstock et al., 1988) where higher perceived risk leads to more preventive health behavior. Personal risk estimates vary significantly depending on whether individuals are rating their subjective risk alone (absolute risk perception) or relative to a standard (comparative risk perception), such as the risk of other individuals. Absolute and comparative risk perception of

FAQs

What was the main objective of the PROBASE-related study?

To assess how common prostate cancer worry is and which factors are associated with absolute and comparative risk perception in a community sample of 45-year-old men.

How were worry and risk perception measured in the study?

Worry about prostate cancer and absolute/comparative risk perception were assessed with self-report questionnaires and a clinical interview, each using a 5-point Likert scale.

Which factors were associated with higher prostate cancer worry and risk perception?

Lower urinary tract symptoms and a positive prostate cancer family history were important factors, while a positive history of urological and non-urological cancers related to higher comparative risk perception.

Aug 30, 2026

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