Men's experiences of the Swedish Organised Prostate Cancer Testing programme: a qualitative study

Objectives: To investigate men's experiences of undergoing the diagnostic pathway within the Swedish Organised Prostate Cancer Testing (OPT) programme in Stockholm County. Subjects and methods: The OPT in Sweden is a structured programme aimed at reducing unnecessary medical interventions while ensuring early detection. Men in selected age groups receive an invitation, including information on the benefits and risks of prostate-specific antigen (PSA) testing. Those with PSA levels above a pre-defined threshold (≥3 ng/mL) are referred for magnetic resonance imaging (MRI) to assess the need for further evaluation. If MRI indicates a biopsy is needed, men are referred to urology for targeted and/or systematic biopsy. To explore men's experiences with the diagnostic pathway of the OPT, semi-structured interviews were conducted with 22 participants in Stockholm County. Thematic analysis was used to identify, analyse, and describe patterns within the data. Results: After their initial PSA test, informants expressed a need for more guidance in interpreting their test results. At the MRI stage, they requested clearer information, as it requires preparations that could otherwise be overlooked. For the biopsy, informants desired more support before and after the procedure, as it can trigger fear and anxiety. Overall, they perceived the diagnostic pathway as efficient but too automated. They requested more personalised information and support, especially towards the end of the process. Conclusion: This study shows that the OPT programme was well received by participating men; however, they requested more personalised information and support throughout the process. These needs increased further along the diagnostic pathway as the examinations became more invasive and the risk of detecting prostate cancer increased. Patient perspectives need to be considered to improve this programme and similar programmes in the future.