No increase in shared decision-making for PSA testing but discussions have broadened

March 13, 2018

Although health care organizations differ in their recommendations for use of prostate-specific antigen testing for prostate cancer screening, they agree that the decision to undergo PSA testing should be shared by patients and clinicians. A new study finds that although there has been no increase in shared decision-making for PSA testing, the content of discussions has become more comprehensive. The study compared responses to the National Health Interview Survey in 2010 and 2015 among men age 50 and older (n=9598). In this nationally representative sample, a similar proportion (approximately 60 percent) of men with recent PSA testing reported one or more elements of shared decision-making in both 2010 and 2015. They also reported a modest shift away from discussions limited to the advantages of PSA testing toward full shared decision-making in which advantages, disadvantages, and uncertainties were discussed (12 percent of recently-tested men in 2010 compared to 17 percent in 2015). One in 10 men who did not receive PSA testing reported receiving one or more elements of shared decision-making, a number which did not change during the study period. The results suggest that, contrary to guideline recommendations, many men receiving PSA testing still do not receive shared decision-making and a limited number of men without PSA testing receive one or more shared decision-making elements. The authors call for new and innovative strategies to achieve more widespread application of shared decision-making for men considering PSA testing.

Recent Patterns in Shared Decision Making for Prostate-Specific Antigen Testing in the United States
Stacey A Fedewa, PhD, MPH, et al
American Cancer Society, Atlanta, Georgia

American Academy of Family Physicians

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