A Randomized Controlled Trial to Promote Physician-Patient Discussion of Prostate Cancer Screening
Condition: Prostate Cancer
MeSH terms: Prostatic Neoplasms
Study type: Interventional

Summary: 
      Prostate cancer is the most common type of cancer among men. It is also the second leading
      cause of cancer-related death among men. Two screening tests are available to try to detect
      prostate cancer early - the digital rectal examination (DRE) and the prostate specific
      antigen (PSA) blood test. Unfortunately, physicians aren't sure whether or not these two
      screening tests help save lives, and there's a lot of controversy about how to use them.
      Recently, a major government committee (the U.S. Preventive Services Task Force) recommended
      that physicians discuss the risks and potential benefits of prostate cancer screening with
      their patients, and allow patients to make their own decision.

      Because of the controversies, many physicians currently don't discuss prostate cancer with
      their patients. The problem is that it takes time and effort to have these discussions, and
      the information is complicated. A lot of patients have trouble understanding it, especially
      if they have a limited educational background or trouble reading. When patients have
      difficulty obtaining, understanding, and acting on basic health information, we say that they
      have "low health literacy." Other researchers have shown that patients with low health
      literacy don't know as much about cancer screening and are less likely to get screened for
      various cancers. They also tend to be timid about discussing things with their doctor, and
      often go along with what the doctor says, rather than taking an active role in the decision
      making.

      In 2003, under IRB approval, we conducted a study with 2 goals: 1) to encourage patients to
      talk to their doctor about prostate cancer screening, and 2) to learn more about the impact
      of low health literacy on these conversations. To promote conversation, we used two handouts,
      given to patients in the waiting room before they saw the doctor. The first was a patient
      education handout about prostate cancer screening, written in very simple terms with useful
      illustrations. The second was a handout that simply encouraged patients to talk to their
      doctor about prostate cancer. Patients got one of the two handouts, or a nutritional handout
      that served as a control. After they saw their doctor, a research assistant briefly
      interviewed the patient to find out whether or not prostate cancer screening was discussed.
      We also measured the patients' health literacy skills, and asked a few other questions about
      their decision to get screened for prostate cancer.
    


Intervention name(s): Educational handout about prostate cancer screening; Simple cue for patient to talk to doctor
Intervention type(s): Procedure; Procedure
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: Single
Primary purpose: Educational/Counseling/Training
Keywords: Health literacy; Physician-Patient Relationship; Prostate Cancer