Prostate cancer survivors' beliefs about screening and treatment decision-making experiences in an era of controversy.
OBJECTIVE
Controversy about the costs and benefits of screening and treatment of prostate cancer (PCa) has recently intensified. However, the impact of the debate on PCa patients has not been systematically studied.


METHODS
We assessed knowledge of, and attitudes toward, the U.S. Preventive Services Task Force's (USPSTF) May 2012 recommendation against PSA-based screening among men diagnosed with clinically localized PCa, and tested whether exposure to the recommendation and associated controversy about overtreatment of PCa predicted treatment decisional conflict, affected treatment choice, or increased regret about PSA testing.


RESULTS
Accurate knowledge of the USPSTF recommendation was uncommon (19.1%). Attitudes toward the recommendation were negative, and the vast majority (86.5%) remained highly supportive of annual PSA testing in men ≥50. Although exposure to the recommendation and controversy about treatment was associated with lower enthusiasm for screening and treatment, it was not associated with treatment decisions, or greater decisional-conflict, or regret.


CONCLUSIONS
Findings may alleviate concern that exposure to PSA-based screening and overtreatment controversies has adversely affected recent cohorts of PCa patients. However, patients remain highly supportive of PSA-based screening. As survivor anecdotes often influence people's medical decisions, it is important to appreciate the scale of opposition to the new recommendation.
Community Health and Health Behavior, University at Buffalo, 3435 Main St., Buffalo, NY, 14214, USA.
Heather
H
Orom
Urologic Oncology, Roswell Park Cancer Institute, Elm & Carlton, Buffalo, NY, 14263, USA.
Willie
W
Underwood
Community Health and Health Behavior, University at Buffalo, 3435 Main St., Buffalo, NY, 14214, USA.
D Lynn
DL
Homish
Community Health and Health Behavior, University at Buffalo, 3435 Main St., Buffalo, NY, 14214, USA.
Marc T
MT
Kiviniemi
Community Health and Health Behavior, University at Buffalo, 3435 Main St., Buffalo, NY, 14214, USA.
Gregory G
GG
Homish
Memorial Sloan-Kettering Cancer Center, 641 Lexington Ave, New York, NY, 10022, USA.
Christian J
CJ
Nelson
Houston Metro Urology P. A., 4223 Richmond Ave, Houston, TX, 77027, USA.
Zvi
Z
Schiffman
D000368:Aged; D003220:Conflict, Psychological; D003657:Decision Making; D034462:Dissent and Disputes; D055088:Early Detection of Cancer / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000523:psychology / Q000628:therapy*; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D014481:United States
D017430:Prostate-Specific Antigen
cancer screening; decision making; oncology; prostate cancer; prostate-specific antigen (PSA); survivorship