Delivering the unexpected—Information needs for PSA screening from Men's perspective: A qualitative study

Abstract

Background Making decisions about PSA screening tests is challenging, as it requires both knowledge of the possible benefits and harms of screening and an individual assessment of the patient's values. Our research explores how much and what information men perceive to be necessary with regard to screening for prostate cancer. Objective To explore men's information and associated needs for decision making in PSA testing. Design Qualitative interview study. Setting and participants We interviewed 32 men (aged 55‐69) about their decision making on PSA screening following counselling with a Decision Aid at their GP’s or urologist's practice in Germany. Main Outcome Measures Men's expressed needs for decision making in PSA testing. Methods All interviews were transcribed verbatim and analysed by framework analysis. Results Comprehensive pre‐screening counselling is needed. For the men in our study, information about test (in)accuracy, the benefit‐harm balance and consequences of the test were relevant and surprising. Additional needs were for interpretation support, a take‐home summary and time for deliberation. For several men, their physician's attitude was of interest. After being well‐informed, most men felt empowered to make a preference‐based decision on their own. Discussion Men were surprised by what they learned, especially regarding the accuracy and possible harms of screening. There is large variation in the breadth and depth of information needed, and some controversy regarding the consequences of testing. Conclusion and patient contribution A core set of information should be offered before men make their first PSA screening decision. Information about biopsy and associated side‐effects could follow in a short form, with details only on request. Knowledge about a high rate of false‐positive test results beforehand might help men handle a suspicious test result.

Decision aid and cost compensation influence uptake of PSA-based early detection without affecting decisional conflict: a cluster randomised trial

“…These modules are explicitly designed for a use during the consultation between physician and patient (“transactional”). As recommended by the International Patient Decision Aids Standards (IPDAS) the DA was designed and pre-evaluated within a multiple-step mixed-methods pilot study at the Department of General Practice Philipps-University Marburg, Germany 9 , 12 , 13 . After a qualitative field-test, the DA was modified according to user’s feedback.…”

Mixed-Method Systematic Review and Meta-Analysis of Shared Decision-Making Tools for Cancer Screening

“…Of the 21 included qualitative studies, a total of 10 studies encompassed both vulnerable individuals and clinicians [79][80][81][82][83][84][85][86][87][88], while 8 studies exclusively focused on vulnerable individuals [45,[89][90][91][92][93][94][95] and 3 studies solely involved clinicians [96][97][98] (Supplementary File S2, Table S3).…”

“…Several studies were conducted in Europe (n = 7), including in Spain [87,98], France [80], Portugal [89], Belgium [83], Germany [84], and Denmark [94], as well as in the United States (n = 11) [45,81,82,85,88,[90][91][92][93]96,97], Canada [95], and England [79].…”

Men’s perception of information and psychological distress in the diagnostic phase of prostate cancer: a comparative mixed methods study

“…Furthermore, the monitoring practices of patients with a raised PSA may leave uncertainty about further stages of the process [ 16 ]. Although men may be aware of the PSA test, insufficient knowledge about what the test entails has been reported [ 7 , 18 , 19 ]. For example, men were often unfamiliar with the limitations of the test (20).…”