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Published on: May 2, 2013
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Recent Patterns in Shared Decision Making for Prostate-Specific Antigen Testing in the United States.
Stacey A Fedewa1, Ted Gansler2, Robert Smith3
1Intramural Research Department, American Cancer Society, Atlanta, Georiga stacey.fedewa@cancer.org.
Annals of Family Medicine
|March 14, 2018
Summary
Shared decision making in prostate-specific antigen (PSA) testing did not increase between 2010 and 2015. However, there was a shift towards more comprehensive discussions, though many men still did not receive shared decision making.
Area of Science:
- Urology
- Public Health
- Health Services Research
Background:
- Shared decision making (SDM) is crucial for informed choices in medical care.
- Previous research indicated infrequent SDM for prostate-specific antigen (PSA) testing.
- Recent guidelines emphasize SDM in prostate cancer screening.
Purpose of the Study:
- To assess recent trends in SDM for PSA testing among US men.
- To determine if increased emphasis on SDM has impacted its utilization.
Main Methods:
- Retrospective cross-sectional study using 2010 and 2015 National Health Interview Survey (NHIS) data.
- Analysis included 9,598 men aged 50+.
- SDM elements assessed: advantages only, advantages/disadvantages, and full SDM (including uncertainties).
Main Results:
- Among men with recent PSA testing, SDM receipt was 58.5% (2010) and 62.6% (2015), a non-significant increase.
- Full SDM prevalence significantly increased (aPR=1.51), while discussion of advantages only significantly declined (aPR=0.82).
- SDM remained low and unchanged among men without prior PSA testing (10%).
Conclusions:
- No overall increase in SDM for PSA testing was observed between 2010-2015.
- A notable shift occurred from limited to comprehensive SDM discussions.
- A significant proportion of men undergoing PSA testing still lack adequate SDM.
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