Men's Attitudes Towards Participation in Organised Prostate Cancer Testing: An Abductive Thematic Analysis

Background and objective: Organised prostate cancer (PCa) testing (OPT) was introduced in Sweden to gain knowledge in preparation for a potential national PCa screening programme. This study aims to explore men's opinions regarding the OPT invitation letters and the attitudes influencing their decision to participate in or decline OPT.

Methods: We conducted semi-structured telephone interviews with 30 men (nine participants and 21 non-participants) from Stockholm County who received OPT invitations. We employed an abductive thematic analysis, a reflexive process of identifying theoretical explanations of emerging patterns, to identify themes in men's responses.

Key findings and limitations: Informants found the invitation letters informative and appreciated the screening opportunity, but suggested improvements regarding conciseness and clarity about the risks and benefits of testing. Barriers to participation included lack of time or motivation, fear of discovering illness, inaccessibility, and distrust of health care or medical procedures. Facilitators included a desire to confirm or rule out PCa, and taking advantage of the available screening opportunity. Limitations include the study's single-county focus and a potential recall bias affecting responses.

Conclusions and clinical implications: Men's attitudes towards OPT participation are multifaceted. While men appreciate screening opportunities, practical considerations as well as personal and psychological factors influence their participation decisions. To improve informed decision-making, OPT communication should be clear about the benefits and risks, and accessibility and logistical challenges should be addressed. Enhancing understanding and reducing fears are essential for refining screening practices and aligning these with men's needs.

Patient summary: Men value the option for prostate cancer screening, but face barriers such as low motivation and fear of a cancer diagnosis. Clear communication could improve their understanding of screening and encourage informed decision-making regarding participation in organised prostate cancer testing. Improved accessibility to testing could enhance participant opportunity.