Decision aids reduce men's conflict about PSA screening, but don't change their decisions

July 29, 2013

Men who decide to be screened for prostate cancer and those who forgo PSA screening stick with their decisions after receiving materials explaining the risks and benefits of the test. The decision aids greatly increased their knowledge about screening and reduced their conflict about what to do, but did not have an impact on their screening decision when measured a year later.

That's the finding of a new study published today in JAMA Internal Medicine that examined both web-based and printed tools aimed at helping make informed decisions about PSA testing.

In May 2012, the US Preventive Services Task Force recommended against all men for prostate cancer. Most health professional groups recommend shared decision making so that men can understand the limitations of screening before making a decision about being tested.

"The history of conflicting recommendations for and the mixed messages about screening effectiveness make it critical to assist men in making informed decisions," explains Kathryn Taylor, Ph.D., professor in the Cancer Prevention and Control Program at Georgetown Lombardi Comprehensive Cancer Center.

Taylor and her colleagues developed two decision aids to help men weigh the pros and cons of testing and then make about screening. In one of the largest and most representative conducted on this topic, a racially diverse group of 1,879 men aged 45 to 70 were randomly assigned to utilize a print-based decision aid, an interactive web-based decision aid, or usual care (no decision aid). Telephone interviews were conducted at the start of the study, one month after the start and again at 13 months to see if the tool had a long-term impact.

"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 explains.

After the surveys were conducted, the researchers found that both the web-based and print tools increased the men's knowledge and reduced the initial conflict they reported about whether or not to be screened, and increased their immediate satisfaction with their decision.

"Interestingly, we thought these decision aids might lead to more men forgoing testing, but in fact, the men didn't change their screening plans," says Taylor, adding, "The men told us these tools helped them resolve their own conflicts about whether or not to receive screening." And the study suggested a positive trend in men's long-term satisfaction with their decisions, important because men face the decision about screening every year.

"Ultimately, the decision to receive PSA screening for lies with men," Taylor concludes. "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," Taylor says.

Importantly, the print- and web-based decision aids were equally effective in improving knowledge and reducing decisional conflict, suggesting that either tool may be used, depending on an individual's preferred medium, Taylor says.

"They both have the potential to be easily adopted in real-world practice settings," Taylor concludes. "Given the demonstrated beneficial effect of the decision aids, work is now needed to understand the best methods for widespread dissemination."

Explore further: Men say they want prostate cancer test, despite risks

More information: JAMA Intern Med. Published online July 29, 2013. doi:10.1001/jamainternmed.2013.9253

Related Stories

Men say they want prostate cancer test, despite risks

July 9, 2013
A survey of men age 40 to 74 found that 54 percent said that they would still opt for a popular prostate cancer screening test despite recent recommendations that the test not be performed, finds a new study in American Journal ...

Study finds gaps in 'decision aids' designed to help determine right cancer screening option

May 10, 2013
When it comes to a cancer diagnosis, timing can be everything – the sooner it's found, the more treatable it is. But when and how often should someone get screened?

Prostate-specific antigen screening: Values and techniques shape decisions

February 11, 2013
What's most important to a man as he decides whether or not to undergo prostate-specific antigen- PSA- screening for prostate cancer? What does he value most about the screening? And what's the best way to present the information ...

Many men not told pros, cons of PSA testing, survey finds

July 8, 2013
(HealthDay)—Many doctors insulate their patients from the complexities surrounding the PSA test, and instead decide on their own whether to screen for prostate cancer or not, a new study finds.

PSA screening to detect prostate cancer can be beneficial to younger and at-risk men: study

May 7, 2012
Screening younger men and men at risk of prostate cancer can be beneficial in reducing metastatic cancer and deaths and should not be abandoned, states an article published in CMAJ (Canadian Medical Association Journal).

Benefits of prostate-specific antigen testing remain unclear

July 20, 2012
(HealthDay) -- It remains unclear whether the benefits of prostate-specific antigen (PSA) testing outweigh the harms, but evidence suggests that men with a longer life expectancy may benefit from testing, according to a provisional ...

Recommended for you

Stem cell therapy attacks cancer by targeting unique tissue stiffness

July 26, 2017
A stem cell-based method created by University of California, Irvine scientists can selectively target and kill cancerous tissue while preventing some of the toxic side effects of chemotherapy by treating the disease in a ...

Understanding cell segregation mechanisms that help prevent cancer spread

July 26, 2017
Scientists have uncovered how cells are kept in the right place as the body develops, which may shed light on what causes invasive cancer cells to migrate.

Study uncovers potential 'silver bullet' for preventing and treating colon cancer

July 26, 2017
In preclinical experiments, researchers at VCU Massey Cancer Center have uncovered a new way in which colon cancer develops, as well as a potential "silver bullet" for preventing and treating it. The findings may extend to ...

Compound shows promise in treating melanoma

July 26, 2017
While past attempts to treat melanoma failed to meet expectations, an international team of researchers are hopeful that a compound they tested on both mice and on human cells in a petri dish takes a positive step toward ...

Study may explain failure of retinoic acid trials against breast cancer

July 25, 2017
Estrogen-positive breast cancers are often treated with anti-estrogen therapies. But about half of these cancers contain a subpopulation of cells marked by the protein cytokeratin 5 (CK5), which resists treatment—and breast ...

Breaking the genetic resistance of lung cancer and melanoma

July 25, 2017
Researchers from Monash University and the Memorial Sloan Kettering Cancer Center (MSKCC, New York) have discovered why some cancers – particularly lung cancer and melanoma – are able to quickly develop deadly resistance ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.