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Study supports ‘Decision Aids’ for men
considering Prostate Test
Newswise — Healthy middle-aged men who watch
extensive online presentations about
prostate cancer are more likely to
understand the disease than those who simply
visit health Web sites, according to a new
study. The men are also slightly less
inclined to undergo a routine but somewhat
controversial prostate test.
The findings show how “decision aids” can
“help people understand what the options are
in a neutral way so they can make the
decisions that fit best with their health,”
said lead study author Dominick Frosch, an
assistant professor of medicine at the
University of California at Los Angeles.
At issue is how to help men decisions about
whether to undergo a prostate-specific
antigen (PSA) test. While some doctors
support routinely giving the test to healthy
men, others question its value.
“We don’t have any evidence that would tell
us that screening for prostate cancer in men
without symptoms would help them live
longer,” Frosch said. In many cases, men go
on to die of other causes because the
prostate cancer never reaches a fatal stage.
“What men are really facing is a difficult
decision between an uncertain benefit in
terms of prolonging your life and a
treatment that can really hamper your
quality of life,” Frosch said.
In the study, 611 healthy men ages 50 and
older who visited a Kaiser Permanente clinic
in San Diego were assigned to visit public
prostate-cancer Web sites or view online
presentations designed to help them make
decisions.
The study findings appear in the February 25
issue of Archives of Internal Medicine.
Those who watched the online presentations
scored higher on tests about prostate
knowledge than those who visited the public
Web sites. After taking part in the study,
they were about 9 percent less likely to
want to undergo a PSA test than those who
only visited Web sites, who were about 3
percent less likely to undergo the test.
At the beginning of the study, 96 percent of
the men expressed interest in a PSA test. By
the end, 89 percent did.
Dr. David Rovner, a professor emeritus at
Michigan State University who studies
medical decision-making, said the study did
not examine whether rejecting the test was
“an appropriate decision for specific men.”
Dr. Steven Freedland, an assistant professor
of urology and pathology at Duke University,
said the study is “somewhat biased” against
PSA screening. Even after learning more
about the topic, however, men still wanted
to take the test, he said.
“The moral of the story is that men want PSA
tests,” Freedland said. “And even when
highly educated (about the topic) they want
PSA tests.”
Frosch DL, et al. A randomized controlled
trial comparing alternative approaches for
men considering prostate cancer screening.
Arch Intern Med 168(4), 2008.
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