Men who have undergone screening for prostate-specific antigen or who have declined such testing say they often received only limited information about the test from their physicians, according to a survey of a nationally representative sample of men in the general U.S. population.
Only 21% of the men said that their physicians discussed the pros and cons of PSA screening and asked about their preference, as is recommended in virtually all guidelines from major professional organizations.
Dr. Richard M. Hoffman of the New Mexico VA Health Care System, Albuquerque, and his associates assessed these issues as part of the National Survey of Medical Decisions (DECISIONS) study, a survey of Americans aged 40 and older designed to characterize the decision-making process in various medical issues. The prostate cancer module of this study surveyed men who had accepted or declined PSA screening during the past 2 years.
Overall, 30% of the respondents said they never discussed PSA testing with their physician before deciding whether to undergo screening, a finding that Dr. Hoffman and his colleagues termed “disconcerting.” Fully 45% said they were never asked about their preference regarding PSA testing.
Of those whose physicians did discuss PSA testing, 87% discussed only the benefits and not the disadvantages of screening. Among men whose physicians discussed PSA testing, 79% went on to have the test done (Arch. Intern. Med. 2009;169:1611-18). No financial conflicts of interest were reported.