Prostate Cancer Screening Decision Making Under Controversy: Implications for Health Promotion Practice

Gwede, Clement K.; McDermott, Robert J.

doi:10.1177/1524839904263682

Cited by 19 publications

(13 citation statements)

References 62 publications

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“…Resnick found that educating older adults about the risks and benefits of screening resulted in more realistic expectations about screening 21 . However, educating people about the complexities of screening may be challenging, as demonstrated by experience with prostate cancer screening [22][23][24] .…”

Section: Discussionmentioning

confidence: 99%

Plans to Stop Cancer Screening Tests Among Adults Who Recently Considered Screening

et al. 2010

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OBJECTIVE:We sought to estimate what proportion of adults plan to stop cancer screening tests among adults who recently considered screening and to explore factors associated with these screening plans. DESIGN: Telephone SurveyPARTICIPANTS: A total of 1,237 participants aged 50 and older who reported having made one or more cancer screening decisions in the past 2 years completed 1,454 cancer screening modules for breast, prostate and colorectal screening. MAIN RESULTS:Of all module respondents, 9.8% reported plans to stop screening, 12.6% for breast, 6.0 % for prostate and 9.5% for colon cancer. We found no statistically significant differences in plans to stop for those ages≥70 (8.2%) compared to those ages 50 to 69 (10.2%) (p=0.14.) Black respondents were less likely to report plans to stop than white respondents (OR=0.32, 95% CI 0.12, 0.87). Participation in the decision-making process was associated with plans to stop screening; those who reported they made the final decision about screening (OR 5.9, 95% CI 1.4, 24.7) or made the decision with the health care provider (OR 4.1, 95% CI 1.0, 16.8) were more likely to have plans to stop screening compared to respondents who reported that their health care provider made the final decision.CONCLUSIONS: Plans to stop screening were uncommon among participants who had recently faced a screening decision. Given the recent US Preventive Services Task Force recommendations limiting routine cancer screening for older adults, additional efforts to educate adults about the potential risks and benefits of screening may be warranted.KEY WORDS: cancer screening; decision making; aged.

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Section: Discussionmentioning

confidence: 99%

Plans to Stop Cancer Screening Tests Among Adults Who Recently Considered Screening

et al. 2010

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“…2 These stark statistics led to increased PCa screening for all men with the introduction of serum prostate specific antigen (PSA) testing in the late 1980s. However, screening with PSA has been controversial since its introduction, due to uncertainty about the impact of PSA screening in reducing mortality, 3 its non-specificity for PCa, and its inability to gauge PCa aggressiveness. 4 Recommendations have shifted from encouraging PSA screening 5 to discouraging it as the standard of care.…”

Section: Introductionmentioning

confidence: 99%

Interventions to Improve Decision Making and Reduce Racial and Ethnic Disparities in the Management of Prostate Cancer: A Systematic Review

2012

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OBJECTIVES: Ethnic minorities are disproportionately impacted by prostate cancer (PCa) and are at risk for not receiving informed decision making (IDM). We conducted a systematic literature review on interventions to improve: (1) IDM about PCa in screeningeligible minority men, and (2) quality of life (QOL) in minority PCa survivors. DATA SOURCES: MeSH headings for PCa, ethnic minorities, and interventions were searched in MED-LINE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, CINAHL, and PsycINFO. SUBJECT ELIGIBILITY CRITERIA: We identified U.S.-based, English-language articles (1985-2010) on interventions to improve PCa IDM and QOL that included 50 % or more minority patients or analyses stratified by race/ethnicity. STUDY APPRAISAL AND SYNTHESIS METHODS:Articles (n=19) were evaluated and scored for quality using a Downs and Black (DB) system. Interventions were organized by those enhancing 1) IDM about PCa screening and 2) improving QOL and symptom among PCa survivors. Outcomes were reported by intervention type (educational seminar, printed material, telephonebased, video and web-based). RESULTS: Fourteen studies evaluated interventions for enhancing IDM about PCa screening and five evaluated programs to improve outcomes for PCa survivors. Knowledge scores were statistically significantly increased in 12 of 13 screening studies that measured knowledge, with ranges of effect varying across intervention types: educational programs (13 %-48 % increase), print (11 %-18 %), videotape/DVD (16 %), and web-based (7 %-20 %). In the final screening study, an intervention to improve decision-making about screening increased decisional self-efficacy by 9 %. Five cognitive-behavioral interventions improved QOL among minority men being treated for localized PCa through enhancing problem solving and coping skills. LIMITATIONS: Weak study designs, small sample sizes, selection biases, and variation in follow-up intervals across studies. CONCLUSIONS: Educational programs were the most effective intervention for improving knowledge among screening-eligible minority men. Cognitive behavioral strategies improved QOL for minority men treated for localized PCa.

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“…However, some professional organizations caution that the potential benefits of preventative screening do not outweigh the risks, e.g., psychological impact from false positives, infection or rectal bleeding, financial cost and time commitments. (10,11) AA men have a high risk of prostate cancer, yet they have low prostate cancer screening rates. (12,13) It is not surprising that given the lack of consensus within the medical community about the benefits of screening, an inherent suspicion of the medical establishment and the practicalities of insurance costs and access to screening, that AA men are reluctant to participate in cancer control and screening programs.…”

Section: Introductionmentioning

confidence: 99%

Using Focus Groups to Adapt Ethnically Appropriate, Information-Seeking and Recruitment Messages for a Prostate Cancer Screening Program for Men at High Risk

Bryan

Wetmore-Arkader

Calvano

et al. 2008

Journal of the National Medical Association

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Purpose-To adapt ethnically appropriate radio and newspaper messages in order to increase information seeking and recruitment to a high risk Prostate Cancer Risk Assessment Program (PRAP) using input from focus groups.Methods-We conducted 4 gender-and ethnic specific-focus groups composed of up to 8 participants each. Group participants ranged in age from 35-69 and were either at risk for prostate cancer or were married to someone at risk. Participants evaluated both print and radio advertisements for a PRAP media recruitment campaign and their recommendations were used to adapt the advertisements.Results-"Trigger words", e.g., "research program" were found to be a particular issue for African American men who cited concerns about "experimentation", while the other groups cited concerns about time commitments and cost. In the print messages, familial themes garnered an overall favorable response, but Caucasian American (CAs) participants responded negatively to the use of photos of age appropriate models.Conclusion-Focus groups are useful in checking health professional assumptions about health messages prior to developing awareness or recruitment advertisements or materials. There was an implied preference for "younger" models among CAs. Radio and print messages were adapted using the focus group recommendations, i.e,. focusing on familial themes, adding race specific risk estimates, and using younger-than-target group models.

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Prostate Cancer Screening Decision Making Under Controversy: Implications for Health Promotion Practice

Cited by 19 publications

References 62 publications

Plans to Stop Cancer Screening Tests Among Adults Who Recently Considered Screening

Plans to Stop Cancer Screening Tests Among Adults Who Recently Considered Screening

Interventions to Improve Decision Making and Reduce Racial and Ethnic Disparities in the Management of Prostate Cancer: A Systematic Review

Using Focus Groups to Adapt Ethnically Appropriate, Information-Seeking and Recruitment Messages for a Prostate Cancer Screening Program for Men at High Risk

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