Screening for prostate cancer with the prostate-specific antigen test - Are patients making informed decisions?

BACKGROUND. The benefits of early detection of prostate cancer are uncertai n, and the American College of Physicians and the American Academy of Famil y Physicians recommend individual decision making in prostate cancer screen ing. This study reports the knowledge of male primary cave patients about p rostate cancer and prostate-specific antigen (PSA) testing and examines how that knowledge is related to PSA testing, preferences for testing in the f uture, and desire for involvement in physician-patient decision making, METHODS. The sample included 160 men aged 45 to 70 years with no history of prostate cancer who presented for care at a university-based family medici ne clinic. Before scheduled office visits, patients completed a questionnai re developed for this study that included a IO-question measure of prostate cancer knowledge, the Deber-Kraestchmer Problem-Solving Decision-Making Sc ale, sociodemographic indicators, and questions on PSA testing. RESULTS. In general, patients who were college graduates were more knowledg eable about prostate cancer and early detection than those with a high scho ol education or less. Aside from college graduates, most patients could not identify the principle advantages and disadvantages of PSA testing. Patien ts indicating previous or future plans for PSA testing demonstrated greater knowledge than other patients. Desire for involvement in decision making v aried by patient education but was not related to past PSA testing. CONCLUSIONS. Patients lack knowledge about prostate cancer and early detect ion. This knowledge deficit may impede the early detection of prostate canc er and is a barrier to making an informed decision about undergoing PSA tes ting.