Benefits Of Prostate-specific Antigen Testing Research Articles

Abstract PO-249: Prostate screening & patient knowledge on PSA testing among males: Analysis of the 2019 NHIS

Abstract Intro: Prostate cancer, one of the most common cancers for males, continues to have non-standardized screening with Prostate Specific Antigen (PSA) due to the potential risks and uncertainties that PSA screening can pose. Methods: The purpose of this study is to investigate the knowledge base of participants regarding the advantages and disadvantages of PSA screening. Using the 2019 National Health Interview Survey, we performed descriptive statistics on participant demographics and prostate screening questions. Bivariate and multivariable logistic regression was utilized to highlight variables that were associated with whether or not a doctor explained to a participant the advantages and disadvantages of PSA testing. Results: Overall, we gathered answers from 10,165 respondents aged 40 years or older, from a total of 31,997 participants in the 2019 NHIS survey. Nearly half of respondents (5004, 49.2%) reported that they had undergone a PSA test in the past and 38.6% of respondents reported that a doctor had discussed the advantages of a PSA test. On the other hand, only 25.8% reported that a doctor had discussed possible disadvantages of PSA testing. Our stratified analyses found that Asians were less likely to report that a doctor had discussed the advantages of a PSA test (OR = 0.59, P < 0.05). We also found that the higher the educational status of a participant, the more likely a participant would report that a doctor talked about the advantages of a PSA test (high school graduates, OR = 1.83, P<0.05; college degrees, OR = 2.48, P < 0.05). Those without any form of health insurance coverage were less likely to be told about the advantages of PSA testing (OR = 0.60, P< 0.05). Similar values in each of these covariates were also found to be statistically significant when participants were asked if a doctor had talked to them about the disadvantages of a PSA test. Conclusions: We found disparities of prostate cancer screening education based on social factors, which reinforce concerns of disparate access of information provided by physicians on the advantages and disadvantages of a PSA testing. Our findings support a call for the improvement of adequate patient-doctor discussions that fully address the risks and benefits of PSA testing. Citation Format: Isabela M. Bumanlag, Humberto R. Nieves-Jimenez, Joseph Abi Jaoude, Ethan B. Ludmir, Cullen M. Taniguchi. Prostate screening & patient knowledge on PSA testing among males: Analysis of the 2019 NHIS [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-249.

Does shared decision making increase prostate screening uptake in countries with a low prevalence of prostate cancer?

Men over 50 should discuss the benefits and harms of prostate-specific antigen (PSA) testing with their doctors. To investigate whether shared decision making (SDM) increases the uptake of prostate cancer screening practices among Saudi men. This community-based study recruited men aged ≥ 50 years between January and April 2019. Sociodemographic characteristics, history, and current medical condition information were collected. SDM information with regards to prostate cancer screening was discussed. In total, 2034 Saudi men, aged between 50 and 88 years, agreed to participate in the current study. Prostate examination for early detection of cancer was recommended for 35.4% (720) of subjects. Of the subjects, 23.3% (473) reported that the physicians discussed the advantages and benefits of PSA testing, whereas only 5.6% (114) stated that the physicians explained the disadvantages and drawbacks of PSA testing. Our findings suggest that less than one fourth discussed the advantages and disadvantages of PSA testing with their physicians; of these, less than one third underwent PSA blood tests. Improvements are needed in SDM for and against PSA screening. SDM does not affect the intensity of PSA testing. Primary health care physicians should be actively involved in the SDM process.

Prostate examination among adult and elderly subjects in southern Brazil: a cross-sectional population-based study.

Population-wide screening for prostate cancer remains a controversial topic, given the need for an individualized approach to patients regarding the risks and benefits of prostate-specific antigen testing and digital rectal examination. The aim of this study was to investigate the prevalence of, and factors associated with, prostate examination among men aged 45 or older. Cross-sectional population-based study developed in the city of Rio Grande (RS), Brazil. The outcome of interest was a history of prostate examination (prostate-specific antigen testing or digital rectal examination). The following independent variables were analyzed: age group, skin color, marital status, schooling, economic level, leisure-time physical activity, smoking habits, excessive alcohol consumption, overweight, health insurance, visits to the doctor during the preceding year, hypertension and diabetes. After a two-stage sampling process, the final sample consisted of 281 male individuals. The prevalence of a history of prostate-specific antigen testing or digital rectal examination was 68.3% (95% confidence interval (CI): 62.2 to 74.5). The highest prevalence rates were observed among men aged 70 years or older (88%) and the lowest among smokers (36%). The following characteristics were found to be associated with the outcome: advanced age; marital status other than single; more schooling and higher economic status; practicing physical activity; non-smoking habits; overweight; having health insurance; and having visited a doctor during the preceding year. Approximately two thirds of the study population had been screened for prostate examination, mostly older individuals, with higher socioeconomic status and a healthier lifestyle.

PSA Screening for Prostate Cancer in Men under the Age of 65: A Review of Current Practice

Purpose: To review current practice in the use of Prostate Specific Antigen (PSA) testing and assess the overall risks and benefits of PSA testing for Adenocarcinoma of the Prostate, specifically in men under age 65, and those living with risk factors for the disease. Materials and Methods: An extensive literature review of PSA testing in various age groups was conducted with the goal being to review PSA screening trends and assess current recommendations regarding PSA Screening for Adenocarcinoma of the Prostate in various age groups, focusing on studies directed towards patients under the age of 65 and the long-term risks and benefits of PSA screening in the diagnostic algorithm. In order to reduce bias, we assessed our sources for variables such as reporting, measurement and/or selection bias. Our conclusions were then compared with current recommendations. Relevant studies with data compiled after 2004, centered around PSA screening in men under the age of 65 in general and specifically in men with risk factors for developing Adenocarcinoma of the Prostate were included. Editorials, newspaper articles and other non-scholarly and non-peer reviewed sources were automatically excluded.

All care, but whose responsibility? Community juries reason about expert and patient responsibilities in prostate-specific antigen screening for prostate cancer

General practitioners have implicitly been given responsibility for guiding men's decisions about prostate-specific antigen-based screening for prostate cancer, but patients' expectations of the bounds of this responsibility remain unclear. We sought to explore how well-informed members of the public allocate responsibilities in prostate-specific antigen screening decision-making. In 2014, we convened two Community juries in Sydney, Australia, to address questions related to the content and timing of information provision and respective roles of patients and general practitioners in screening decisions. Participants in the first jury were of mixed gender and of all ages (n = 15); the participants in the second jury were all male and of screening age (n = 12). Both juries were presented with balanced factual evidence on the harms and benefits of prostate-specific antigen screening and expert perspectives on ethico-legal aspects of consent in medical practice. In their deliberations, jurors agreed that general practitioners should take responsibility for informing men of the options, risks and benefits of prostate-specific antigen testing, but arrived at different positions on whether or not general practitioners should also guide screening decisions. Jurors also disagreed on how much and when general practitioners should provide detailed information about biopsies and treatments. These responses suggest that for prostate-specific antigen testing, there is a public expectation that both the allocation of responsibility between general practitioners and their male patients, and the level of information provided will be tailored to individual men. In the presence of expert uncertainty, a well-informed public may have reason to embrace or resist shared decision-making processes.

Predictors of prostate cancer screening intention among older men in Jordan

ABSTRACTIntention to prostate cancer screening (PCS) is one of the major factors affecting the long‐term success of population‐based PCS programmes. The aim of this study is to explore strong factors linked to intention to PCS among older Jordanian adults using the Health Belief Model (HBM). Data were obtained from Jordanian older adults, aged 40 years and over, who visited a comprehensive health care centre within a ministry of health. A pilot test was conducted to investigate the internal consistency of the Champion Health Belief Model Scale for PCS and the clarity of survey questions. Sample characteristics and rates of participation in PCS were examined using means and frequencies. Important factors associated with intention to PCS were examined using bivariate correlation and standard multiple linear regression analysis. About 13% of the respondents were adherent to PCS over the prior decade. Four out of the seven HBM‐driven factors (perceived susceptibility, benefits and barriers to prostate‐specific antigen (PSA) test, and health motivation) were statistically significant. Those with greater levels of susceptibility, benefits of PSA test and health motivation and lower levels of barriers to PSA testing were having more intention to participate in PCS. Family history, presence of urinary symptoms, age and knowledge about prostate cancer significantly predicted the intention to PCS. Intervention programmes, which lower perceived barriers to PSA testing and increase susceptibility, benefits of PSA testing and health motivation, should be developed and implemented.