Patient education for informed decision making about prostate cancer screening: a randomized controlled trial with 1-year follow-up.
OBJECTIVE
The efficacy of prostate cancer screening is uncertain, and professional organizations recommend educating patients about potential harms and benefits. We evaluated the effect of a videotape decision aid on promoting informed decision making about prostate cancer screening among primary care patients.


METHODS
A group of 160 men, 45 to 70 years of age, with no history of prostate cancer, were randomized to view or not to view a 20-minute educational videotape before a routine office visit at a university-based family medicine clinic. The subjects were contacted again 1 year after their visit to assess their receipt of prostate cancer screening (digital rectal examination [DRE] or prostate-specific antigen [PSA] testing), their satisfaction with their screening decision, and knowledge retention since the baseline assessment.


RESULTS
Follow-up assessments were completed for 87.5% of the intervention subjects and 83.8% of the control subjects. The rate of DRE did not differ between the 2 groups. Prostate-specific antigen testing was reported by 24 of 70 (34.3%) intervention subjects and 37 of 67 (55.2%) control subjects (P = .01). African American men were more likely to have had PSA testing (9 of 16, 56.3%) than were white men (13 of 46, 28.3%) (P = .044). Satisfaction with the screening decision did not differ between the study groups. Intervention subjects were more knowledgeable of prostate cancer screening than were control subjects, although these differences declined within 1 year (P < .001).


CONCLUSIONS
Decision aids for prostate cancer screening can have a long-term effect on screening behavior and appear to promote informed decision making.
Volk
Robert J
RJ
Department of Family and Community Medicine, Baylor College of Medicine, Houston, Tex 77098-3915, USA. bvolk@bcm.tmc.edu
Spann
Stephen J
SJ
Cass
Alvab R
AR
Hawley
Sarah T
ST
D000368:Aged; D003657:Decision Making; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010808:Physical Examination / Q000379:methods; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis*; D012007:Rectum; D014743:Videotape Recording
D017430:Prostate-Specific Antigen