Pre-screening Discussions and Prostate-Specific Antigen Testing for Prostate Cancer Screening.

Area of Science:

• Urology
• Public Health
• Health Services Research

Background:

• Prostate cancer screening with prostate-specific antigen (PSA) tests offers limited net benefit for many men.
• Major medical organizations emphasize shared decision-making for PSA testing due to conflicting recommendations.
• Understanding factors influencing PSA test uptake is crucial for patient-centered care.

Purpose of the Study:

• To investigate the association between discussions of PSA testing benefits and harms and the uptake of PSA tests.
• To analyze screening test uptake among men aged 40 years and older based on pre-screening discussions.

Main Methods:

• Utilized self-reported data from the 2012 Behavioral Risk Factor Surveillance System.
• Estimated unadjusted prevalence of PSA testing.
• Calculated adjusted odds ratios (AORs) using logistic regression in 2014.

Main Results:

• Men who discussed PSA testing advantages only or both advantages and disadvantages were more likely to have been tested.
• Men who discussed only the disadvantages of PSA testing showed a higher likelihood of testing (AOR=2.75).
• Any discussion regarding PSA testing benefits or harms was positively associated with test uptake.

Conclusions:

• Discussions about the benefits or harms of PSA testing positively correlate with increased test uptake.
• Highlights the need to understand how pre-screening discussions are conducted in clinical practice.
• Emphasizes the role of patient values and preferences in prostate cancer screening decisions.