Men may not get enough information about risks of prostate cancer screening

Results from the DECISIONS study showed that although most respondents discussed prostate cancer screening with a physician, only 20.6% discussed both possible risk and benefits of PSA testing and almost half could not answer any of the three survey questions about prostate cancer.

Researchers conducted a 46-question telephone survey of 3,010 American men aged 40 or older from November 2006 to May 2007. Of this sample, 375 have undergone or discussed PSA testing with their health care provider within the last two years.

Overall, 69.9% of men had discussed prostate cancer screening with a health care provider. The provider brought up the subject most of the time (64.6%). Also, 84.4% of respondents considered themselves at average or low risk for prostate cancer and 93.1% believed screening would reduce disease-specific mortality.

Hoffman and colleagues asked participants three questions about prostate cancer:

Of every 100 men, about how many do you think will die of prostate cancer?
Of 100 men, about how many will be diagnosed as having prostate cancer at some time in their lives?
For every 100 times a PSA test result suggests the need for further testing, about how many times does it turn out to be cancer?

Even though 58% of the men considered themselves “very well informed” about prostate cancer, only 7.2% could correctly answer more than one question; 47.8% got all three questions wrong.

The researchers said men at low, average and high risk all substantially overestimated their lifetime risk for prostate cancer and the researchers also found an inverse relationship between feeling informed and correctly answering the question about lifetime incidence risk.

Hoffman RM. Arch Intern Med. 2009;169:1611-1618.