Study: Print, Web aids help decide on cancer screening

NEW YORK: Both print and online tools outlining the possible benefits and harms of prostate cancer screening can help men understand the disease and feel more confident in their screening-related decisions, a new study suggests.
Researchers found, however, that men who had access to those decision aids weren’t any more or less likely to be screened in the following year than those who didn’t receive extra information.
“We really wanted to develop something that clearly presented both sides of the issue so that men could make an informed decision with regards to whether they wanted to undergo screening,” said Kathryn Taylor, who led the new study at Georgetown University in Washington, D.C.
Last year, the US Preventive Services Task Force (USPSTF), a government-backed panel, recommended against prostate specific antigen (PSA) tests for average-risk men.
Other groups, including the American Urological Association, say men of certain ages should weigh the risks and benefits with their doctors and come to an individual decision about screening.
Data conflict about whether screening saves any lives. It’s clearer that treatment after a positive test and biopsy can cause side effects, such as impotence and incontinence, and that some cancers picked up on screening would never have caused symptoms because they are so slow-growing.
Taylor and her colleagues randomly assigned close to 1,900 middle-aged men to receive print or Internet-based prostate cancer decision aids or no extra information.
Both tools contained information on the prostate gland, prostate cancer screening tests and treatment options, as well as prompts to help men define their screening-related values and encouragement to talk about screening with a doctor. The web version also included video testimonials and pop-up definitions of some terms.
Before receiving any information, men in each of the three groups scored an average of 10.4 on an 18-question exam about prostate cancer. One month later, men who had received either print or web decision aids scored a 13.5, versus 11.1 among those in the comparison group.
Those differences shrank slightly but remained a year later, the study team wrote in JAMA Internal Medicine.
One thing that didn’t change was the proportion of men who decided to get screened: across study groups, between 45 and 48 percent of participants had a PSA test in the year following the study.
But after receiving decision aids, 60 percent of those in the print group and 52 percent in the web-based group reported a high satisfaction with their screening decisions, compared to 46 percent of the men who received usual care.
Taylor said lingering uncertainty about the PSA test and its potential benefits may have contributed to men continuing to get screened.
“The fact that it’s easy to do, the fact that many doctors recommend it or perhaps don’t discuss it and just do it, all make it easier to just undergo the test,” she told Reuters Health.