Informed decision making on PSA testing for the detection of prostate cancer: An evaluation of a leaflet with risk indicator
Background: Population-based screening for prostate cancer (PCa) remains controversial. To help men making informed decisions about prostate specific antigen (PSA) screening a risk indicator (www.uroweb.org) was developed. This risk indicator is embedded in a leaflet that informs men about the pros and cons of PCa screening and enables calculation of the individual risk of having a biopsy detectable PCa. Aim: To assess the effect of providing a leaflet including individualized risk estimation on informed decision making of men, i.e. knowledge about PCa and PSA screening, attitude towards undergoing a PSA test and intention to have a PSA test. Methods: An intervention study among 2000 men, aged 55-65 years, randomly selected from the population registry of the city of Dordrecht, the Netherlands, in 2008. Men were sent a questionnaire on knowledge of PCa, attitude and intention to have a PSA test. Men without a history of (screening for) PCa were sent the leaflet and Questionnaire 2 within 2 weeks after returning Questionnaire 1. Validated health and anxiety measures were used. Results: One thousand and twenty seven of 2000 men completed Questionnaire 1 (51%), of whom 298 were excluded due to a history of (screening for) PCa. Of the 729 remaining men, 601 completed Questionnaire 2 as well. At the second assessment significantly more men met the requirements of informed decision making (15% versus 33%, p < 0.001), more men had relevant knowledge (284/601, 50% versus 420/601, 77%, p < 0.001) and the intention to have a PSA test had increased (p < 0.001). Conclusions: Providing information on PCa screening combined with individualized risk estimation enhanced informed decision making and may be used for shared decision making on PSA screening of physicians and patients.
|Keywords||Informed choice, Informed decision making, PSA test, Prostate Risk Indicator, Prostate cancer, Screening|
|Persistent URL||dx.doi.org/10.1016/j.ejca.2009.11.022, hdl.handle.net/1765/28168|
van Vugt, H.A., Roobol, M.J., Venderbos, L.D.F., Joosten-van Zwanenburg, E., Essink-Bot, M.L.E., Steyerberg, E.W., … Korfage, I.J.. (2010). Informed decision making on PSA testing for the detection of prostate cancer: An evaluation of a leaflet with risk indicator. European Journal of Cancer, 46(3), 669–677. doi:10.1016/j.ejca.2009.11.022