Impact of a Printed Decision Aid on Patients' Intent to Undertake Prostate Cancer Screening
Condition: Prostate Cancer
MeSH terms: Prostatic Neoplasms
Study type: Interventional

Summary: 
      Although the number of recommendations against systematic screening of prostate cancer, 70%
      of patients still request testing because they overestimate the benefits and are unaware of
      the limitations.

      The investigators aim is to assess the impact of a short printed decision aid presenting
      benefits and limits of screening, on patients' intent to undergo prostate cancer screening.
    

Detailed description: 
      A Cochrane systematic review of 5 randomized controlled trials showed that screening for
      prostate cancer, using digital rectal examination and dosage of prostate specific antigen
      (PSA), did not significantly decrease prostate cancer specific mortality. Rather, screening
      for prostate cancer often led to over-diagnosis by detecting tumors that would not otherwise
      have become symptomatic or by producing false positive results. It could therefore result in
      unnecessary supplementary testing (including prostate biopsies), inadequate and/or harmful
      treatment, and negative psychological outcomes among patients.

      Although the growing number of recommendations against PSA testing for screening of prostate
      cancer, 70% of patients still request testing prior to any information because they
      overestimate the benefits and are unaware of the limitations. As a result, about 55% of
      patients between 50 and 74 years old, undergo prostate cancer screening in the USA every
      year, despite recommendations against it.

      To help patients understand the complexities about PSA testing for prostate cancer screening,
      professional organizations encourage physicians and patients to use decision aids to make
      informed decisions.

      The aim of this study was to evaluate the impact of a decision aid, usable in daily practice
      by general practitioners, presenting harms and benefits of prostate cancer screening on
      patients' intent to undergo screening.
    

Intervention name(s): Decision aid
Intervention type(s): Other
Intervention description(s): Intervention was use of a decision aid. Decision aid contained information about: 1) the epidemiology of prostate cancer; 2) what is a PSA test and advantages and limits of screening for prostate cancer using it (including risk of overtreatment and risk of becoming impotent and/or incontinent) and; 3) the position on screening for prostate cancer of major scientific societies in France at the time of the study. The second page contained a visual representation of the benefits of PSA screening for prostate cancer versus usual care based on the results of the European Randomized study of Screening for Prostate Cancer trial (ERSPC) The decision aid was pretested with 20 patients to ensure clarity and wording. It was revised accordingly to comments.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Screening
Keywords: Prostate cancer; Screening; Decision aids