Prostate cancer screening is controversial; treatment of early stage cancer has uncertain benefits, and complications are likely.
Physician-patient discussions about PSA testing may be brief or absent. We investigated men's familiarity and experiences with PSA testing, and perceived benefits and barriers. Methods In the context of the multi-site CRN study "Health Literacy and Cancer Prevention" men aged 40-70 were interviewed about knowledge, attitudes and experiences related to PSA testing. Results: Of 437 men queried, 69% had heard of a PSA test, and 51% knew what type of cancer it tested for. 246 men had/intended PSA screening (PSA-accepters). The most common reasons cited for screening were physician recommendation (62%), age appropriateness (49%), and prostate-related symptoms (12%). 21 men had not been/did not intend to be tested (PSA-decliners); reasons included no physician recommendation (33%), age (19%), and no prostate issues (10%). Most men (83%) would find a normal result reassuring, and most (80%) believed a PSA test would reduce their chances of dying from prostate cancer; accepters held stronger beliefs about these benefits than decliners (p< .10). Overall, 24% would be nervous about what a PSA test might find and 13% agreed having a PSA test is unpleasant. The latter belief (but not the former) was stronger in PSA-decliners than accepters (p< .05). There were no statistically significant differences between PSA-accepters and decliners on health literacy test scores, however those who did not know what sort of cancer a PSA test screened for scored lower than those who did (p< .05). Overall, 35% of men had read or been given conflicting information about PSA testing; these men were more likely to report mixed feelings about PSA testing, would be less likely to find a normal result reassuring, and were less likely to believe that PSA testing reduces chances of dying from prostate cancer (p< .05). Conclusions Many men in this study were unfamiliar with PSA testing. Most believed that PSA testing would reduce their chances of dying from prostate cancer, and were not aware of conflicting information about PSA testing. Patient education about PSA testing is needed.
Mazor K, Mooradian M, Costanza M, Field T, Gaglio B, Greene S, Han P, Robinson B, Roblin D, Wagner J, Williams A. Are you the author?
Reference: Clin Med Res. 2011 Nov;9(3-4):147-8.