Most professional organizations, including the American College of Physicians and U.S. Preventive Services Task Force, emphasize that screening for prostate cancer with the prostate-specific antigen (PSA) test should only occur after a detailed discussion between the health-care provider and patient about the known risks and potential benefits of the test.
In fact, guidelines strongly advise health-care providers to involve patients, particularly those at elevated risk of prostate cancer, in a "shared decision making" (SDM) process about PSA testing. We analyzed data from the National Cancer Institute's Health Information National Trends Survey 2011-2012-a nationally representative, cross-sectional survey-to examine the extent to which health professionals provided men with information critical to SDM prior to PSA testing, including (1) that patients had a choice about whether or not to undergo PSA testing, (2) that not all doctors recommend PSA testing, and (3) that no one is sure if PSA testing saves lives. Over half (55 %) of men between the ages of 50 and 74 reported ever having had a PSA test. However, only 10 % of men, regardless of screening status, reported receiving all three pieces of information: 55 % reported being informed that they could choose whether or not to undergo testing, 22 % reported being informed that some doctors recommend PSA testing and others do not, and 14 % reported being informed that no one is sure if PSA testing actually saves lives. Black men and men with lower levels of education were less likely to be provided this information. There is a need to improve patient-provider communication about the uncertainties associated with the PSA test. Interventions directed at patients, providers, and practice settings should be considered.
Journal of cancer education : the official journal of the American Association for Cancer Education. 2015 Oct 26 [Epub ahead of print]
Bryan Leyva, Alexander Persoskie, Allison Ottenbacher, Jada G Hamilton, Jennifer D Allen, Sarah C Kobrin, Stephen H Taplin
Process of Care Research Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr. 3E230, Bethesda, MD, 20892, USA. Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. , Science of Research and Technology Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. , Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA. , Department of Public Health and Community Medicine, Tufts University, Boston, MA, USA. , Process of Care Research Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr. 3E230, Bethesda, MD, 20892, USA. , Process of Care Research Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr. 3E230, Bethesda, MD, 20892, USA.