A Simple Schema for Informed Decision Making About Prostate Cancer Screening
Authors: Andrew J. Vickers, Kelly Edwards, Matthew R. Cooperberg, Alvin I. Mushlin
Journal: Annals of Internal Medicine (2014)

Ideas and Opinions16 September 2014A Simple Schema for Informed Decision Making About Prostate Cancer ScreeningAndrew J. Vickers, PhD, Kelly Edwards, PhD, Matthew R. Cooperberg, MD, MPH, and Alvin I. Mushlin, MD, ScMAndrew J. Vickers, PhDFrom Memorial Sloan Kettering Cancer Center and Weill Cornell Medical Center, New York, New York; University of Washington School of Medicine, Seattle, Washington; and UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California., Kelly Edwards, PhDFrom Memorial Sloan Kettering Cancer Center and Weill Cornell Medical Center, New York, New York; University of Washington School of Medicine, Seattle, Washington; and UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California., Matthew R. Cooperberg, MD, MPHFrom Memorial Sloan Kettering Cancer Center and Weill Cornell Medical Center, New York, New York; University of Washington School of Medicine, Seattle, Washington; and UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California., and Alvin I. Mushlin, MD, ScMFrom Memorial Sloan Kettering Cancer Center and Weill Cornell Medical Center, New York, New York; University of Washington School of Medicine, Seattle, Washington; and UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M14-0151 SectionsSupplemental MaterialAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Screening for prostate cancer with prostate-specific antigen (PSA) testing is a problematic aspect of primary care. With the exception of the U.S. Preventive Services Task Force, which made an influential (1) but highly criticized (2) recommendation against any early detection efforts based on PSA testing, most organizations recommend that an informed decision be made by the patient after discussion with a physician. For example, the American College of Physicians is generally skeptical of the benefits of PSA testing ("for most … men, the harms will outweigh the benefits") but recommends that "doctors and patients should discuss the potential benefits and ...References1. Chou R, LeFevre ML. Prostate cancer screening—the evidence, the recommendations, and the clinical implications. JAMA. 2011;306:2721-2. [PMID: 22203543] doi:10.1001/jama.2011.1891 CrossrefMedlineGoogle Scholar2. Carlsson S, Vickers AJ, Roobol M, Eastham J, Scardino P, Lilja H, et al. Prostate cancer screening: facts, statistics, and interpretation in response to the US Preventive Services Task Force Review. J Clin Oncol. 2012;30:2581-4. [PMID: 22711853] doi:10.1200/JCO.2011.40.4327 CrossrefMedlineGoogle Scholar3. American College of Physicians. American College of Physicians releases new prostate cancer screening guidance statement [news release]. Philadelphia: American College of Physicians; 9 April 2013. Accessed at www.acponline.org/pressroom/prostate_cancer_screening.htm on 31 July 2014. Google Scholar4. Qaseem A, Barry MJ, Denberg TD, Owens DK, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. Screening for prostate cancer: a guidance statement from the Clinical Guidelines Committee of the American College of Physicians. Ann Intern Med. 2013;158:761-9. [PMID: 23567643] doi:10.7326/0003-4819-158-10-201305210-00633 LinkGoogle Scholar5. Carter HB, Albertsen PC, Barry MJ, Etzioni R, Freedland SJ, Greene KL, et al. Early detection of prostate cancer: AUA Guideline. J Urol. 2013;190:419-26. [PMID: 23659877] doi:10.1016/j.juro.2013.04.119 CrossrefMedlineGoogle Scholar6. Feng B, Srinivasan M, Hoffman JR, Rainwater JA, Griffin E, Dragojevic M, et al. Physician communication regarding prostate cancer screening: analysis of unannounced standardized patient visits. Ann Fam Med. 2013;11:315-23. [PMID: 23835817] doi:10.1370/afm.1509 CrossrefMedlineGoogle Scholar7. National Cancer Institute. Prostate-Specific Antigen (PSA) Test. Bethesda, MD: National Institutes of Health; 2012. Accessed at www.cancer.gov/cancertopics/factsheet/detection/PSA on 29 July 2014. Google Scholar8. Giguere A, Légaré F, Grad R, Pluye P, Haynes RB, Cauchon M, et al. Decision boxes for clinicians to support evidence-based practice and shared decision making: the user experience. Implement Sci. 2012;7:72. [PMID: 22862935] doi:10.1186/1748-5908-7-72 CrossrefMedlineGoogle Scholar9. Gaster B, Edwards K, Trinidad SB, Gallagher TH, Braddock CH. Patient-centered discussions about prostate cancer screening: a real-world approach. Ann Intern Med. 2010;153:661-5. [PMID: 21079223] doi:10.7326/0003-4819-153-10-201011160-00010 LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Andrew J. Vickers, PhD; Kelly Edwards, PhD; Matthew R. Cooperberg, MD, MPH; Alvin I. Mushlin, MD, ScMAffiliations: From Memorial Sloan Kettering Cancer Center and Weill Cornell Medical Center, New York, New York; University of Washington School of Medicine, Seattle, Washington; and UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California.Grant Support: This work was supported by the National Cancer Institute (R01CA160816, R01 CA175491, and P50-CA92629), the Sidney Kimmel Center for Prostate and Urologic Cancers, and David H. Koch through the Prostate Cancer Foundation. Dr. Mushlin was supported in part by grant UL1 RR024996 from the National Center for Research Resources of the National Institutes of Health (Clinical and Translational Science Center award). Dr. Edwards was supported in part by the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute through the Cancer Prevention and Control Research Network, a network within the CDC's Prevention Research Centers Program (grant 1-U48-DP-000050).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-0151.Corresponding Author: Andrew J. Vickers, PhD, Memorial Sloan Kettering Cancer Center, 307 East 63rd Street, 2nd Floor, Box 44, New York, NY 10065; e-mail, VickersA@mskcc.org.Current Author Addresses: Dr. Vickers: Memorial Sloan Kettering Cancer Center, 307 East 63rd Street, 2nd Floor, Box 44, New York, NY 10065.Dr. Edwards: Department of Bioethics and Humanities, University of Washington School of Medicine, Box 357120, Seattle, WA 98195.Dr. Cooperberg: University of California, San Francisco, Box 1695, 1600 Divisadero Street, A-607, San Francisco, CA 94143-1695.Dr. Mushlin: Weill Cornell Medical Center, Department of Public Health, 402 East 67th Street, New York, NY 10065.Author Contributions: Conception and design: A.J. Vickers, K. Edwards.Analysis and interpretation of the data: A.J. Vickers, A.I. Mushlin.Drafting of the article: A.J. Vickers, K. Edwards, M.R. Cooperberg, A.I. Mushlin.Critical revision of the article for important intellectual content: A.J. Vickers, K. Edwards, M.R. Cooperberg, A.I. Mushlin.Final approval of the article: A.J. Vickers, K. Edwards, M.R. Cooperberg, A.I. Mushlin. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoInformed Decision Making About Prostate Cancer Screening Michael E. O'Callaghan , Ganessan Kichenadasse , Sina Vatandoust , and Kim Moretti Informed Decision Making About Prostate Cancer Screening Andrew J. 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O'Callaghan, BSc(Hons), PhD, Ganessan Kichenadasse, MBBS, Sina Vatandoust, MD, and Kim Moretti, MBBSRe: Relative Value of Race, Family History and Prostate Specific Antigen as Indications for Early Initiation of Prostate Cancer ScreeningLong-Term Active Surveillance for Prostate Cancer: Answers and Questions 16 September 2014Volume 161, Issue 6Page: 441-442KeywordsAntigensCancer preventionCancer screeningDecision makingDeep vein thrombosisDisclosurePrevention, policy, and public healthPrimary care physiciansProstate cancerResearch grants ePublished: 16 September 2014 Issue Published: 16 September 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...