USA-What has your doctor told you about PSA testing?

This is taken from The "New" Prostate Cancer InfoLink:

 Posted on July 9, 2013 by Sitemaster

According to a recent article in the Annals of Family Medicine, about 64 percent of 3,400 men aged between 50 and 74 years of age who participated in a survey conducted in 2010 stated that they had never had a conversation with their doctor about the pros and cons of PSA testing.
There is already a nice summary of this paper available on the HealthDay web site, and we see little point in repeating the same information here. The full text of the original paper by Han et al. is also accessible on line.
The bottom line is perhaps best encapsulated in some comments made by Dr. Robert Ferrer, the vice chair for research in the department of family and community medicine at University of Texas Health Science Center at San Antonio, as follows:

• Doctors have “a duty to help patients understand in situations where there are competing benefits and harms.”
• “The PSA decision is no more complex than many other health care decisions.”
• The medical profession needs to find ways to educate patients even if doctor visits are brief and cluttered with other tasks.
• Clinicians have a responsibility to help patients make decisions consistent with their preferences.

Now that sounds like one of the most sensible sets of comments we have heard about PSA testing in the past 20+ years!
The article by Han et al. is, in fact, just one of four articles dealing with PSA testing that are available in this issue of the Annals for Family Medicine. They are, probably, all worth reading together as a group:

• Han PJK, et al. “National evidence on the use of shared decision making in prostate-specific antigen screening” is the article previously referred to above
• Feng B, et al. “Physician communication regarding prostate cancer screening: analysis of unannounced standardized patient visits” is another study looking at the use of how physicians used a web-based tool to discuss PSA testing with their patients.
• Wilkes MS,. et al. “Pairing physician education with patient activation to improve shared decisions in prostate cancer screening: a cluster randomized controlled trial” provides data from a study designed to assess one way to improve the shared decision-making process between doctors and patients.
• Ferrer RM, Gill LM “Shared decision making, contextualized” is an editorial that offers insights into whether the primary care community is really convinced that “shared decision making” is an operating principle that must be fully accepted and acted on by most primary care doctors today.

There is a real value to the patient community of being well aware of research and discussion like this that is going on within the primary care community. It can be balanced against the more dogmatic “guidelines” issued by everyone from the U.S. Preventive Services Task Force to the American Urological Association.


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