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Published on: November 2, 2013
Shared decision making in prostate-specific antigen testing with men older than 70 years.
Jun Li1, Zahava Berkowitz, Thomas B Richards
1Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. ffa2@cdc.gov
Summary
Shared decision making (SDM) discussions about prostate-specific antigen (PSA) testing benefits and drawbacks are linked to higher testing rates in older men. More research is needed on SDM in PSA screening.
Area of Science:
- Urology
- Public Health
- Health Services Research
Background:
- Shared decision making (SDM) in healthcare for older men, particularly regarding prostate-specific antigen (PSA) testing, is not well understood.
- This study investigates the implementation of key SDM elements and their correlation with PSA testing practices in older men.
Purpose of the Study:
- To describe the utilization of shared decision making (SDM) components in the context of prostate-specific antigen (PSA) testing among older men.
- To evaluate the association between SDM elements and PSA testing rates in this demographic.
Main Methods:
- Analysis of data from the 2005 and 2010 National Health Interview Survey.
- Descriptive statistics and logistic regression modeling were employed to assess associations.
Main Results:
- PSA testing prevalence remained stable between 2005 and 2010, with 44.1% of men aged 70+ receiving testing in 2010.
- Only 27.2% of older men reported discussing both the advantages and disadvantages of PSA testing.
- Discussions of testing advantages (with or without disadvantages) were positively associated with PSA testing (P < .001), while discussion of scientific uncertainties showed no association.
Conclusions:
- Physician awareness and adherence to PSA screening recommendations require improvement.
- Discussions encompassing both pros and cons of PSA testing enhance uptake, whereas discussing scientific uncertainties does not.
- Further research is essential to understand the nuances of SDM, patient knowledge, and preferences in PSA-based screening.
