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More knowledge of prostate
cancer leads to fewer screenings
Newswise — Patients given prostate cancer
information prior to their medical examinations participated more
actively in decision making and were less likely to opt for
screening tests, according to a Virginia Commonwealth University
study released today.
The study, published in the March-April issue
of the Annals of Family Medicine, also found that providing
the information prior to the appointment left the patients more
knowledgeable on the potential benefits and harms associated with
testing for prostate specific antigen, the marker used to screen for
prostate cancer.
The overall result was that men
were more engaged in the decision-making process.
Participants often took significant control over
whether to be screened as opposed to deferring to
the doctor’s opinion.
The study was unclear, however, as to whether
pre-visit educational aids facilitated a broader decision-making
process called “shared decision making,” said Alex Krist, M.D., an
assistant professor of family medicine in the VCU School of
Medicine.
The study enrolled 497 men, between the ages of
50 and 70, who were undergoing a health maintenance examination. The
men were split into test groups that were given either an
Internet-based or paper educational aid or no material at all prior
to their visits with their physicians. The Internet-based aid was
intended to provide an easy means for a doctor’s office to direct
patients to information prior to an office visit.
“Whether to be screened for prostate cancer is
a difficult decision for patients.” Krist said. “Given that informed
patients are less likely to opt for screening, clinicians clearly
need to provide patients information about the risks and benefits of
screening prior to testing. Ultimately, this will allow each
patient’s values to be incorporated into their screening decision.”
Prostate cancer screening has associated risks with uncertain
benefits. Some patients may choose not to be screened because
abnormal results frequently occur due to factors other than cancer,
Krist said. In addition, testing may uncover insignificant cancers
that patients and doctors feel compelled to treat, and treatment has
significant associated risks.
The study was funded by the American Academy of
Family Physicians Foundation under the Junior Grant Awards Program.
A copy may be obtained via email at
kristinr@aafp.org.
About VCU and the VCU Medical Center: Virginia
Commonwealth University is the largest university in Virginia and
ranks among the top 100 universities in the country in sponsored
research. Located on two downtown campuses in Richmond, VCU enrolls
more than 30,000 students in nearly 200 certificate and degree
programs in the arts, sciences and humanities. Sixty-three of the
programs are unique in Virginia, many of them crossing the
disciplines of VCU’s 15 schools and one college. MCV Hospitals and
the health sciences schools of Virginia Commonwealth University
compose the VCU Medical Center, one of the nation’s leading academic
medical centers. For more, see
http://www.vcu.edu.
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