Shared Decision-Making for Prostate Cancer Screening in Racial and Ethnic Minority Populations: A Systematic Review

Prostate cancer screening (PCS) remains controversial in its efficacy, making shared decision-making (SDM) essential to ensure informed choices. However, racial and ethnic minority men in the United States experience persistent disparities in PCS participation and outcomes. Despite these disparities, how SDM interventions have been designed, implemented, and evaluated for these populations remains unclear. To address this gap, this systematic review examined SDM interventions for PCS among minority men, with a specific focus on the extent to which interventions incorporated key SDM features (information exchange, deliberation, and decision implementation).

Six databases (PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Scopus) were used to search for U.S.-based, English-language studies published in the past ten years. We included studies that evaluated SDM interventions for PCS among racial and ethnic minority men.

Eighteen studies met the inclusion criteria. Most targeted African American men, with limited racial/ethnic diversity. The majority of interventions were delivered as single-session programs. While all studies supported information exchange, few incorporated the full spectrum of SDM components. Outcome measures were inconsistent across studies, and critical variables relevant to minority populations, such as trust in healthcare, were not assessed.

These findings illustrate ongoing challenges in both the design and evaluation of SDM interventions, including limited application of core SDM features and lack of population diversity. This review calls for future studies to develop and test culturally adapted, multi-component SDM interventions. Such efforts are needed to advance SDM research and ultimately contribute to more equitable, patient-centered cancer care.