Prostate cancer UK's Risk Checker: help or hindrance to PSA testing policy?

Abstract

The UK has an informed choice prostate cancer testing policy, where the PSA blood test is available for free to any man aged 50 or over who request it and has been informed of the harms and benefits. This leads to differences in PSA testing rates which can exacerbate health inequalities. To assess whether Prostate Cancer UK's Risk Checker helps men at risk of prostate cancer make an informed choice about the PSA test. Mixed methods study, UK. 1,181 men at risk, their partners, and clinical experts participated in surveys, focus groups, and 1:1 interviews. Data on risk checker completions by sociodemographic factors were analysed over time. Data from GP practices that sent the Risk Checker to their patients were collected and analysed for service monitoring purposes. There was a strong assumption that testing must be good, and therefore a need to emphasise the pros and cons of the test and that having it was the patient's decision. Men believed their GP would invite them for PSA testing. 80% of men who completed the risk checker had at least one prostate cancer risk factor. Average time they interacted with the information in the tool was 9 minutes 28 seconds. 75.7% felt the tool had equipped them to make an informed choice. Online decision-making tools like the Risk Checker can help reach men at high risk of prostate cancer and support them in making an informed choice about the PSA test.