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A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance

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Physicians' attitudes about shared decision making for prostate cancer screening.

Kimberly Davis¹, Lisa Haisfield, Caroline Dorfman

¹Georgetown University Medical Center, Washington, DC, USA. Kmd54@georgetown.edu

Family Medicine

|April 19, 2011

Summary

Physicians support shared decision making (SDM) for prostate cancer screening (PCS), but barriers like time and malpractice concerns exist. More effort is needed to effectively engage patients in PCS decisions.

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Area of Science:

Urology
Primary Care Medicine
Health Services Research

Background:

Shared decision making (SDM) is recommended for prostate cancer screening (PCS) due to uncertain risks and benefits.
Physician and patient engagement in PCS decisions is crucial.

Purpose of the Study:

To assess primary care physicians' attitudes towards SDM for PCS.
To identify factors influencing the SDM process in PCS.

Main Methods:

A survey assessed attitudes of academic clinicians (n=16), interns/residents (n=84), and community clinicians (n=35) regarding SDM for PCS.
The 26-item survey explored factors influencing the SDM process.

Main Results:

Most physicians favored SDM (47.4%) or patient-led decisions (35.6%) for PCS, with few preferring to decide unilaterally.
Despite supporting full disclosure, only 36.6% found PSA test sensitivity/specificity adequate.
Common barriers included lack of time, competing demands, malpractice fears, and patient interest.
Community clinicians were more likely to endorse annual screening, express malpractice concerns, and accept PSA test performance.

Conclusions:

Physician, patient, and systemic factors impact PCS decision-making.
Overcoming barriers is essential for promoting effective SDM in PCS, aligning with national guidelines.