Similar perspectives on prostate cancer screening value and new guidelines across patient demographic and PSA level subgroups: A qualitative study.
In 2012, the United States Preventive Services Task Force (USPSTF) recommended against prostate-specific antigen (PSA)-based prostate cancer screening for all men.



To inform educational materials addressing patient questions and concerns about the 2012 USPSTF guidelines, we sought to: (i) characterize patient perceptions about prostate cancer screening benefits, harms and recommendations against screening, and (ii) compare perceptions across race, age and PSA level subgroups.



We conducted qualitative interviews with a sample of 26 men from the Minneapolis Veterans Affairs Health Care System, stratified by race (African American, other), age (50-69, 70-84) and PSA level (documented PSA level ≥4 in Veterans Health Administration electronic medical records vs no such documentation). We used an inductive approach informed by grounded theory to analyse transcribed interviews.



Most men in all subgroups expressed misperceptions about the benefits of prostate cancer screening and had difficulty identifying harms associated with screening. In all subgroups, reactions to recommendations against screening ranged from unconditionally receptive to highly resistant. Some men in every subgroup initially resistant to the idea said they would accept a recommendation to discontinue screening from their provider.



Given the similarity of perceptions and reactions across subgroups, materials targeted by race, age and PSA level may not be necessary. Efforts to inform decision making about prostate cancer screening should address misperceptions about benefits and lack of awareness of harms. Provider perspectives and recommendations may play a pivotal role in shaping patient reactions to new guidelines.
Center for Chronic Disease Outcomes Research (CCDOR), Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA.|Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
Melissa R
MR
Partin
Center for Chronic Disease Outcomes Research (CCDOR), Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA.
Sarah E
SE
Lillie
School of Public Health, University of Minnesota, 1 Veterans Drive, Minneapolis, MN, USA.
Katie M
KM
White
Center for Chronic Disease Outcomes Research (CCDOR), Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA.|Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
Timothy J
TJ
Wilt
Department of Urology, University of Minnesota, Minneapolis, MN, USA.|Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA.
Kristin L
KL
Chrouser
Center for Chronic Disease Outcomes Research (CCDOR), Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA.|Department of Medicine, University of Minnesota, Minneapolis, MN, USA.|School of Public Health, University of Minnesota, 1 Veterans Drive, Minneapolis, MN, USA.
Brent C
BC
Taylor
Center for Chronic Disease Outcomes Research (CCDOR), Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA.|Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
Diana J
DJ
Burgess
D026683:Advisory Committees; D000368:Aged; D000369:Aged, 80 and over; D003710:Demography / Q000706:statistics & numerical data*; D055088:Early Detection of Cancer / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D017430:Prostate-Specific Antigen / Q000032:analysis*; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D036301:Qualitative Research; D014481:United States
D017430:Prostate-Specific Antigen
cancer screening; patient education; practice guideline; prostate cancer; qualitative research; race