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Updated: Jul 6, 2025

Microarray-based Identification of Individual HERV Loci Expression: Application to Biomarker Discovery in Prostate Cancer
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Shared decision-making before prostate cancer screening decisions.

Kelly R Pekala1, Daniela K Shill2, Mia Austria3

  • 1Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Nature Reviews. Urology
|January 3, 2024
PubMed
Summary
This summary is machine-generated.

Shared decision-making (SDM) improves prostate cancer screening knowledge but implementation varies widely. Trust facilitates SDM, while time constraints and low health literacy pose barriers, necessitating improved clinical integration strategies.

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Area of Science:

  • Urology
  • Public Health
  • Health Services Research

Background:

  • Prostate-specific antigen (PSA) screening decisions necessitate a patient-centered approach, balancing benefits against potential harms.
  • Shared decision-making (SDM) is evidence-based for improving patient knowledge and reducing decisional conflict in PSA screening.
  • Implementing SDM in clinical practice presents significant challenges.

Purpose of the Study:

  • To determine the prevalence of SDM in prostate cancer screening decisions using an inclusive definition.
  • To identify facilitators and barriers influencing the practice of SDM in this context.

Main Methods:

  • Systematic review and meta-analysis of studies evaluating SDM in PSA screening decisions.
  • Analysis of prevalence data based on an inclusive SDM definition.
  • Identification of reported facilitators and barriers to SDM implementation.

Main Results:

  • The prevalence of SDM in PSA screening decisions varied significantly (11%-98%), influenced by reporting methods (physician self-report vs. patient recall/observation).
  • Physician-patient trust and relationship continuity were key facilitators of SDM.
  • Limited appointment times and low health literacy were identified as major barriers.

Conclusions:

  • Despite guideline endorsement, SDM in PSA screening is inconsistently implemented.
  • Strategies to overcome barriers like time constraints and improve health literacy are crucial for effective SDM.
  • Further research should focus on practical methods to enhance SDM integration into routine clinical care.