Screening for prostate cancer with the prostate-specific antigen test: are patients making informed decisions?
BACKGROUND
The benefits of early detection of prostate cancer are uncertain, and the American College of Physicians and the American Academy of Family Physicians recommend individual decision making in prostate cancer screening. This study reports the knowledge of male primary care patients about prostate cancer and prostate-specific antigen (PSA) testing and examines how that knowledge is related to PSA testing, preferences for testing in the future, and desire for involvement in physician-patient decision making.


METHODS
The sample included 160 men aged 45 to 70 years with no history of prostate cancer who presented for care at a university-based family medicine clinic. Before scheduled office visits, patients completed a questionnaire developed for this study that included a 10-question measure of prostate cancer knowledge, the Deber-Kraestchmer Problem-Solving Decision-Making Scale, sociodemographic indicators, and questions on PSA testing.


RESULTS
In general, patients who were college graduates were more knowledgeable about prostate cancer and early detection than those with a high school education or less. Aside from college graduates, most patients could not identify the principle advantages and disadvantages of PSA testing. Patients indicating previous or future plans for PSA testing demonstrated greater knowledge than other patients. Desire for involvement in decision making varied by patient education but was not related to past PSA testing.


CONCLUSIONS
Patients lack knowledge about prostate cancer and early detection. This knowledge deficit may impede the early detection of prostate cancer and is a barrier to making an informed decision about undergoing PSA testing.
O'Dell
K J
KJ
Clinical Science Center, University of Alabama School of Medicine-Huntsville Campus, 35801, USA.
Volk
R J
RJ
Cass
A R
AR
Spann
S J
SJ
D000328:Adult; D000368:Aged; D003657:Decision Making; D004522:Educational Status; D005194:Family Practice; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007258:Informed Consent; D019359:Knowledge; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010353:Patient Education as Topic; D010358:Patient Participation; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000523:psychology; D012307:Risk Factors; D012959:Socioeconomic Factors; D013781:Texas
D017430:Prostate-Specific Antigen