Helping Men Resolve Conflicts About Prostate Cancer Screening
Printed or web-based materials are useful for informed decision-making, study finds
Wednesday, July 31, 2013
PSA screening for prostate cancer is controversial. The U.S. Preventive Services Task Force, an independent panel of experts, recommends against using PSA screening for all men. Most medical groups recommend that doctors and patients discuss the issue so men can make an informed decision.
"The history of conflicting recommendations for prostate cancer screening and the mixed messages about screening effectiveness make it critical to assist men in making informed decisions," Kathryn Taylor, a professor in the Cancer Prevention and Control Program at Georgetown Lombardi Comprehensive Cancer Center, said in a Georgetown University Medical Center news release.
Taylor and colleagues developed two types of decision aids -- a print version and a web-based interactive one -- to help men consider the pros and cons of PSA screening before making a decision about whether to have the test.
"The tools were intended neither to encourage nor discourage screening, but instead to present the benefits and limitations of screening to help men make choices consistent with their preferences," Taylor said.
The researchers had nearly 1,900 men, aged 45 to 70, use either the print or web-based aids, or no decision aid. The men were interviewed at the start of the study, and again at one month and 13 months after the start to see if the decision aids had any impact.
Both the web-based and print tools increased men's knowledge about PSA screening, reduced their initial conflict about whether to be screened, and boosted their immediate satisfaction with their decision, according to the study, which was published July 29 in the journal JAMA Internal Medicine.
"Interestingly, we thought these decision aids might lead to more men forgoing testing, but, in fact, the men didn't change their screening plans," Taylor said. "The men told us these tools helped them resolve their own conflicts about whether or not to receive screening."
The study suggested a positive trend in men's long-term satisfaction with their decisions, which is important because men face the decision about screening every year.
"Ultimately, the decision to receive PSA screening for prostate cancer lies with men," Taylor said. "They'll be able to make decisions that are right for them if they have unbiased, updated screening materials that fully explain the risks and benefits."