NEW research presented at the Annual Congress of the European Association of Urology 2026 suggests that screening for prostate cancer has only a modest impact on men’s health-related quality of life and health anxiety, helping address a long-standing evidence gap that has complicated policy decisions around screening programmes.
Study Examines Quality of Life During Prostate Cancer Screening
In the late-breaking abstract, researchers from Karolinska Institutet analysed patient-reported outcomes from men participating in the STHLM3-MRI trial, a large Swedish screening study evaluating blood-based risk testing combined with MRI and targeted biopsy.
Economic evaluations of prostate cancer screening have historically lacked robust preference-based health state values, often relying on assumptions or data derived from breast cancer screening. The researchers aimed to generate more accurate estimates by directly measuring quality of life and health anxiety among men undergoing screening.
The panel study included men aged 50-74 years who were invited to complete digital surveys at up to four time points during the screening pathway: before testing, after receiving blood test results, after MRI, and after biopsy where applicable.
Participants completed the widely used EQ-5D-5L health-related quality-of-life questionnaire alongside the Short Health Anxiety Inventory (SHAI-14). The surveys also included questions assessing willingness to pay for alternative tests that could avoid the discomfort associated with MRI or biopsy.
Response rates ranged from 72.6% at baseline (n=3,996) to 56.3% among those completing surveys after biopsy. Overall, screening had limited impact on quality of life. Mean adjusted EQ-5D-5L index values remained high across time points, ranging from 0.941 to 0.975 depending on the value set used.
Health Anxiety Rises Slightly After Testing
Health anxiety increased slightly during the screening process but remained within the “no or mild anxiety” range. Mean SHAI-14 scores rose from 6.50 at baseline to 7.57 after biopsy.
Men who received positive test results reported higher levels of anxiety than those with negative findings, highlighting the psychological impact of abnormal results.
The study also explored how much participants would pay for less invasive alternatives to current screening procedures. Among those willing to pay, the mean amount was €43 for an alternative to MRI and €277 for an alternative to biopsy.
Findings May Inform Future Prostate Cancer Screening Policy
The authors note that the results may be influenced by selection bias, as participants had previously engaged in screening. However, they conclude that the findings provide important real-world evidence showing that prostate cancer screening has only modest effects on quality of life and anxiety.
These data could improve future economic evaluations and support more evidence-based policy decisions on prostate cancer screening programmes.
Reference
Hao S et al. Closing the knowledge gap to inform policy decision-making: health-related quality of life and health anxiety in men undergoing screening for prostate cancer. Abstract LB002; EAU 2026, 13-16 March, 2026.
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