I didn't know I'd be commenting so soon on PSA screening. This Week's American Journal of Public Health has an article on men's understandnig of PSA testing:
Objectives. This study examined knowledge about prostate-specific antigen (PSA) screening among African Americans and Whites. Because PSA screening for prostate cancer is controversial, professional organizations recommend informed consent for screening.
Methods. Men (n = 304) attending outpatient clinics were surveyed for their knowledge about and experience with screening. Results. Most men did not know the key facts about screening with PSA. African Americans appeared less knowledgeable than Whites, but these differences were mediated by differences in educational level and experience with prostate cancer screening.
Conclusions. Public health efforts to improve informed consent for prostate cancer screening should focus on highlighting the key facts and developing different approaches for men at different levels of formal education and prior experience with screening.
The study made headlines in the Reuters Health News this week:
A number of prominent groups, including the U.S. Preventive Services Task Force and the National Cancer Institute, are opposed to routine PSA screening, saying that the risks of follow-up tests and the side effects of treatment may outweigh the possible benefits for many men.
This is a good thing. The mainstream press rarely discusses the fact that PSA testing is so complicated.
I'm on the lookout for good PSA testing patient handouts. Haven't found much. The American Cancer Society's website recently featured this article on calls for informed consent prior to PSA testing.
But until physicians have good tools (educational materials) that will help them provide patients with adequate and reliable information, I'm not sure we'll be improving our track records much. While I often try to have this discussion with patients, I find that it's a tough one to present in an unbiased manner. Men who expect to have test done "because I get one every year .. cuz I'm supposed to" don't want to hear much about the complexity of this decision … and men who don't want to bother with any tests … don't want to bother with any tests .. so they don't get very engaged in the discussion either.
If you use .. or have seen good PSA education materials, please post a comment and share with the rest of us!