Enhancing Prostate Cancer Screening Literacy Through Shared Decision-Making: Results of a Randomized Trial in a...

Area of Science:

• Urology
• Public Health
• Health Disparities

Background:

• Prostate cancer (PCa) awareness is notably lower in racial and ethnic minority populations compared to the general US population.
• This disparity contributes to delayed diagnoses and increased PCa-specific mortality rates.
• Effective patient education and shared decision-making are crucial for addressing these disparities.

Purpose of the Study:

• To evaluate the utility of a novel decision aid (DA) designed to enhance patient participation in shared decision-making for prostate cancer.
• To assess the impact of the DA on informed decision-making regarding PSA screening and treatment acceptance.

Main Methods:

• A novel DA was developed for vulnerable men and tested in a primary care clinic in Newark, NJ.
• 100 patients were randomized (2:1) into DA and non-DA cohorts, completing pre- and post-surveys.
• Multivariate logistic regression analyzed DA utility and its impact on patient information satisfaction and decision-making.

Main Results:

• DA recipients were significantly more likely to report receiving adequate information about PSA testing (OR 5.811, P=.002).
• Participants using the DA were more satisfied with their decision to screen (OR 4.384, P=.005) and more likely to accept therapy post-diagnosis (OR 5.330, P=.003).
• No significant demographic differences were observed between the DA and non-DA cohorts.

Conclusions:

• The novel decision aid effectively improved informed decision-making for prostate cancer screening in an underserved urban population.
• The DA shows potential as a validated tool to increase prostate cancer screening knowledge and promote shared decision-making.
• This intervention may help mitigate disparities in PCa diagnosis and outcomes.