Does shared decision making increase prostate screening uptake in countries with a low prevalence of prostate cancer?

Area of Science:

• Urology
• Public Health
• Preventive Medicine

Background:

• Prostate-specific antigen (PSA) testing is a key tool for prostate cancer screening in men over 50.
• Informed decision-making regarding PSA testing involves understanding both benefits and harms.
• Shared decision making (SDM) aims to improve patient involvement in healthcare choices.

Purpose of the Study:

• To evaluate the impact of shared decision making (SDM) on prostate cancer screening uptake among Saudi men.
• To assess the extent to which Saudi men aged 50 and above engage in SDM regarding PSA testing.

Main Methods:

• A community-based study involving 2034 Saudi men aged 50 years and older.
• Data collection included sociodemographic information, medical history, and current health status.
• Discussion of SDM principles related to prostate cancer screening was conducted.

Main Results:

• Prostate examination was recommended for 35.4% of participants.
• Only 23.3% of men reported a discussion of PSA testing advantages and benefits with their physicians.
• A significantly lower percentage, 5.6%, received information on the disadvantages and drawbacks of PSA testing.

Conclusions:

• Less than a quarter of men discussed PSA testing pros and cons with physicians, and less than a third underwent PSA tests.
• There is a need to enhance SDM processes for and against PSA screening to ensure informed choices.
• SDM did not significantly alter the intensity of PSA testing, highlighting the importance of primary care physician involvement.