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Most Men Report No Shared Decision Making in PSA Screening

MONDAY, July 8 (HealthDay News) -- Nearly two-thirds of men report an absence of shared decision making related to prostate-specific antigen (PSA) screening, according to a study published in the July/August issue of the Annals of Family Medicine.

Paul K.J. Han, M.D., M.P.H., from the Tufts University School of Medicine in Boston, and colleagues examined the prevalence of shared decision making in PSA screening and non-screening using data from a nationally representative sample of 3,427 men aged 50 to 74 years who participated in the 2010 National Health Interview Survey.

The researchers found that 64.3 percent of men reported having no shared decision making; 27.8 percent reported partial shared decision making; and 8 percent reported full shared decision making with discussion of advantages, disadvantages, and scientific uncertainty relating to screening. No screening was reported by 44.2 percent of men, while 27.8 and 25.1 percent, respectively, reported low- and high-intensity screening. The prevalence of no shared decision making was higher among men who were not screened (88 percent, versus 39 percent among men who underwent high-intensity screening). Black race, Hispanic ethnicity, higher education, health insurance, and physician recommendation correlated with the extent of shared decision making. Older age, higher education, usual source of care, physician recommendation, and partial versus no or full shared decision making correlated with screening intensity.

"Most U.S. men report little shared decision making in PSA screening, and the lack of shared decision making is more prevalent in non-screened than in screened men," the authors write.

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