Key clinical point: Minority men were more likely than white men to have undergone prostate cancer-specific antigen (PSA) testing but were less likely to be told about risks and benefits, which may contribute to lack of shared decision-making and perceived disparities in disease outcomes.

Major finding: Compared with white men, non-Hispanic Black men reported significantly less communication from health care professionals about how some doctors but not others recommend PSA screening (odds ratio 0.16), and less communication about whether PSA tests save lives (OR 0.49).

Study details: The data come from a cross-sectional analysis of 518 aged 18 to 49 years who responded to an online survey between October 2011 and February 2012. The study population was 61% non-Hispanic white men and 11.5% non-Hispanic black men.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Commentary

"The appropriate approach to screening for prostate cancer with prostate-specific antigen (PSA) continues to be controversial. The United States Preventive Services Task force (USPSTF) recommends the use of informed decision-making when considering use of PSA for screening. In this cross-sectional study, Miller et al utilized survey results from a large database to determine whether the extent of communication regarding use of PSA for screening may differ amongst racial and ethnic groups between the ages of 18 and 49. While less than 10% of the entire group had a PSA test (8.5% did), the authors discovered that minority men were more likely to have had a PSA but were less likely to have had discussions regarding the harms and benefits of PSA testing. In the setting of uncertainty regarding the optimal use of PSA screening, more implementation research is needed to determine how to best incorporate informed decision-making into clinical practice.”

Mark Klein, MD