Kj. O'Dell et al., Screening for prostate cancer with the prostate-specific antigen test - Are patients making informed decisions?, J FAM PRACT, 48(9), 1999, pp. 682-688
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.