Interpretation of prostate cancer screening events and outcomes: a focus group study

Professional guidelines call for physicians to provide patients with information to permit informed decision making. We conducted focus groups to obtain reactions to numerical information about events and outcomes related to prostate cancer screening (prevalence, natural history, accuracy of screening, and treatment outcomes). The focus groups were used to help develop a balance sheet, a decision aid that explicitly compares likelihood and value of outcomes. In all, 90 persons participated in 12 focus groups homogeneous in ethnicity (African American, White, Hispanic) and gender. Discussions were transcribed and analyzed using qualitative methods. The view of screening derived by participants from the numerical information was less positive than initial opinions based on the media and confidence in medicine. Participants suggested shorter screening intervals, regular screening, and different treatment methods. No single topic was seen as sufficient for the screening decision. The balance sheet should cover prevalence and outcomes of screening and treatment.