Evaluation of the Patient Acceptability of Automated Communication of Prostate-specific Antigen Results After Local Treatment for Prostate Cancer

Prostate-specific antigen (PSA) monitoring is the cornerstone of prostate cancer (PC) follow-up after radical prostatectomy (RP) and radiotherapy (RT). St. Antonius Hospital (Nieuwegein/Utrecht, The Netherlands) launched the Automatic PSA Project in 2022 for automated digital communication of PSA results. PSA results are reviewed by a clinical team, and stable results are sent via automated messages; while rising PSA prompts referral to a urologist. Automated digital communication of PSA results reduces clinician and outpatient workloads and costs and patient travel. We evaluated the patient acceptability of this approach using the Service User Technology Acceptability Questionnaire. Eligible patients had undergone RP or RT, had stable PSA levels 6 mo after treatment, and had access to the patient portal. Participation was voluntary and limited to men without significant functional symptoms. Between January 2023 and September 2024, 100/325 participants in the project completed the questionnaire. Most men were aged ≥65 yr, had moderate to high digital skills, and had undergone RP (91%). Overall acceptability was high (median score 5.27, interquartile range 4.98-5.75), 72% considered digital PSA communication a suitable replacement, and 95% regarded it as a valuable addition to standard care. Privacy concerns were low. Selection bias could not be ruled out. Digital PSA communication appears to be acceptable and sustainable for selected patients, supporting broader implementation in future PC care.