Journal article
Prostate Cancer Screening Decisions: Results From the National Survey of Medical Decisions (DECISIONS Study)
Archives of internal medicine (1960), Vol.169(17), pp.1611-1618
2009
DOI: 10.1001/archinternmed.2009.262
PMID: 19786681
Abstract
Background: Guidelines recommend informing patients about the risks and benefits of prostate cancer screening. We evaluated the medical decision-making process for prostate-specific antigen (PSA) testing.
Methods: We conducted a telephone survey of a randomly selected national sample of 3010 English-speaking US adults 40 years and older. Included in the survey were 375 men who had either undergone or discussed (with health care providers [HCPs]) PSA testing in the previous 2 years. We asked subjects about sociodemographic characteristics, prostate cancer screening discussion features, prostate cancer knowledge, and the importance of various decision factors and sources of information.
Results: Overall, 69.9% of subjects discussed screening before making a testing decision, including 14.4% who were not tested. Health care providers most often (64.6%) raised the idea of screening, and 73.4% recommended PSA testing. Health care providers emphasized the pros of testing in 71.4% of discussions but infrequently addressed the cons (32.0%). Although 58.0% of subjects felt well-informed about PSA testing, 47.8% failed to correctly answer any of the 3 knowledge questions. Only 54.8% of subjects reported being asked for their screening preferences. An HCP recommendation (odds ratio, 2.67; 95% confidence interval, 1.08-6.58) was the only discussion characteristic associated with testing. Valuing HCP information was also associated with testing (odds ratio, 1.26; 95% confidence interval, 1.04-1.54).
Conclusions: Recommendations and information from HCPs strongly influenced testing decisions. However, most prostate cancer screening decisions did not meet criteria for shared decision making because subjects did not receive balanced discussions of decision consequences, had limited knowledge, and were not routinely asked for their preferences.
Details
- Title: Subtitle
- Prostate Cancer Screening Decisions: Results From the National Survey of Medical Decisions (DECISIONS Study)
- Creators
- Richard M HOFFMAN - Medicine Services, New Mexico VA Health Care System, Albuquerque, United StatesMick P COUPER - Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, United StatesBrian J ZIKMUND-FISHER - Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, United StatesCarrie A LEVIN - Foundation for Informed Medical Decision Making, Boston, Massachusetts, United StatesMary MCNAUGHTON-COLLINS - Division of General Medicine, Massachusetts General Hospital, Boston, United StatesDeborah L HELITZER - Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, United StatesJohn VANHOEWYK - Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, United StatesMichael J BARRY - Division of General Medicine, Massachusetts General Hospital, Boston, United States
- Resource Type
- Journal article
- Publication Details
- Archives of internal medicine (1960), Vol.169(17), pp.1611-1618
- DOI
- 10.1001/archinternmed.2009.262
- PMID
- 19786681
- NLM abbreviation
- Arch Intern Med
- ISSN
- 0003-9926
- eISSN
- 1538-3679
- Publisher
- American Medical Association
- Language
- English
- Date published
- 2009
- Academic Unit
- Epidemiology; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984094350702771
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