Issues In Cancer Screening Research Articles

Implementation strategies preferred by primary care clinicians to facilitate cancer prevention and control activities

Key clinical and community members need to be involved in the identification of feasible and impactful implementation strategies for translation of evidence-based interventions into practice. While a wide range of implementation strategies has been developed, there is little research on their applicability for cancer prevention and control (CPC) efforts in primary care. We conducted a survey of primary care physicians to identify implementation strategies they perceive as most feasible and impactful. The survey included both primary prevention behavior change counseling and cancer screening issues. Analyses contrasted ratings of feasibility and impact of nine implementation strategies, and among clinicians in different settings with a focus on comparisons between clinicians in rural vs. non-rural settings. We recruited a convenience sample of 326 respondents from a wide range of practice types from four practice-based research networks in 49 states and including 177 clinicians in rural settings. Ratings of impact were somewhat higher than those for feasibility. Few of the nine implementation strategies were high on both impact and feasibility. Only ‘adapting to my practice’ was rated higher than a 4 (“moderate”) on both impact and feasibility. There were relatively few differences between rural and non-rural clinicians or associated with other clinician or setting characteristics. There is considerable variability in perceived impact and feasibility of implementation strategies for CPC activities among family medicine clinicians. It is important to assess both feasibility and impact of implementation strategies as well as their generalizability across settings. Our results suggest that optimal strategies to implement evidence-based CPC activities will likely need to be adapted for primary care settings. Future research is needed to replicate these findings and identify practical, implementation partner informed implementation strategies.

Comprehensive Study for Breast Cancer Using Deep Learning and Traditional Machine Learning

Comprehensive Study for Breast Cancer Using Deep Learning and Traditional Machine Learning

A generative adversarial network-based abnormality detection using only normal images for model training with application to digital breast tomosynthesis

Deep learning has shown tremendous potential in the task of object detection in images. However, a common challenge with this task is when only a limited number of images containing the object of interest are available. This is a particular issue in cancer screening, such as digital breast tomosynthesis (DBT), where less than 1% of cases contain cancer. In this study, we propose a method to train an inpainting generative adversarial network to be used for cancer detection using only images that do not contain cancer. During inference, we removed a part of the image and used the network to complete the removed part. A significant error in completing an image part was considered an indication that such location is unexpected and thus abnormal. A large dataset of DBT images used in this study was collected at Duke University. It consisted of 19,230 reconstructed volumes from 4348 patients. Cancerous masses and architectural distortions were marked with bounding boxes by radiologists. Our experiments showed that the locations containing cancer were associated with a notably higher completion error than the non-cancer locations (mean error ratio of 2.77). All data used in this study has been made publicly available by the authors.

THREE METACHRONOUS PRIMARY LUNG CANCERS IN A CHRONIC SMOKER: A CASE REPORT

SESSION TITLE: Fellows Lung Cancer Posters SESSION TYPE: Fellow Case Report Posters PRESENTED ON: October 18-21, 2020 INTRODUCTION: Lung cancer is the worldwide leading cause of cancer-related deaths. Patients once treated curatively for lung cancer can develop subsequent primary lung cancer. Smoking is the major risk factor for the development of lung cancer and contributes to a higher risk of developing a second lung cancer in patients who continue to smoke after diagnosis and treatment of the initial cancer. The subsequent primary lung cancer can be treated successfully, however, both treatment regimen and prognosis depend on whether it is synchronous or metachronous. CASE PRESENTATION: A 60-year-old smoker with 55 pack-year history, presented with cough and hemoptysis. His physical exam was remarkable for clubbing. His pulmonary function testing revealed moderately severe chronic obstructive pulmonary disease (COPD). A Computerized Tomographic (CT) scan revealed a right upper lobe spiculated mass. Positron emission tomography (PET) scan showed standard uptake value (SUV) of 4.5 in the primary tumor and ipsilateral hilar and paratracheal nodes in metastatic range. Histopathologic examination of a transthoracic needle biopsy showed poorly differentiated adenocarcinoma (ADC) of the lung, stage IIIA. The patient was curatively treated with chemotherapy and radiation. After nine years he developed a new posterior left upper lobe spiculated nodule. PET/CT showed it to have an SUV of 4. The patient underwent apical wedge resection of the left upper lobe. Histopathological examination showed moderately differentiated keratinizing squamous cell carcinoma (SCC), stage IA1. He was given extensive counseling on smoking cessation, but he was still not able to quit. Six months later, CT of the chest showed increased soft tissue density and adenopathy of the right hilum with perilymphatic nodules in the right upper and lower lobes consistent with lymphangitic carcinomatosis. The patient underwent transbronchial biopsy reporting a small cell carcinoma (SCLC). Due to poor performance status, he was not a candidate for systemic chemotherapy, and he decided to go into hospice care. DISCUSSION: We reviewed the clinical and pathological features of synchronous and metachronous lung cancers in previously described patients. These patients were below the average age at which first lung cancer diagnosis is made in most patients, had long smoking histories, and histological type occurred in random order. The patients with metachronous cancers continued to smoke after the first or second cancer diagnosis which placed them at a higher risk for subsequent cancer(s). CONCLUSIONS: We recommend that patients with lung cancer diagnosis must quit smoking to reduce the risk of a second primary cancer, and those who do not quit should remain on long-term surveillance. Reference #1: de Groot PM, Wu CC, Carter BW, Munden RF. The epidemiology of lung cancer. Transl Lung Cancer Res. 2018;7(3):220-233. Reference #2: Han SS, Rivera GA, Tammemagi MC, et al. Risk Stratification for Second Primary Lung Cancer. J Clin Oncol. 2017;35(25):2893-2899. Reference #3: Smith RA, Andrews KS, Brooks D, et al. Cancer screening in the United States, 2018: A review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin. 2018;68(4):297-316 DISCLOSURES: No relevant relationships by Boris Betancourt, source=Web Response No relevant relationships by Lillian Chow, source=Web Response No relevant relationships by Dushyant Damania, source=Web Response No relevant relationships by Raavi Gupta, source=Web Response no disclosure on file for M Haseeb; no disclosure on file for Absia Jabbar; No relevant relationships by James Mahoney, source=Admin input No relevant relationships by gurinder sidhu, source=Web Response

Lead-time bias in esophageal cancer screening in high-risk areas in China.

ObjectiveTo investigate what extent lead-time bias is likely to affect endoscopic screening effectiveness for esophageal cancer in the high-risk area in China.MethodsA screening model based on the epidemiological cancer registry data, yielding a population-level incidence and mortality rates, was carried out to simulate study participants in the high-risk area in China, and investigate the effect of lead-time bias on endoscopic screening with control for length bias.ResultsOf 100,000 participants, 6,150 (6.15%) were diagnosed with esophageal squamous dysplasia during the 20-year follow-up period. The estimated lead time ranged from 1.67 to 5.78 years, with a median time of 4.62 years [interquartile range (IQR): 4.07−5.11 years] in the high-risk area in China. Lead-time bias exaggerated screening effectiveness severely, causing more than a 10% overestimation in 5-year cause-specific survival rate and around a 43% reduction in cause-specific hazard ratio. The magnitude of lead-time bias on endoscopic screening for esophageal cancer varied depending on the screening strategies, in which an inverted U-shaped and U-shaped effects were observed in the 5-year cause-specific survival rate and cause-specific hazard ratio respectively concerning a range of ages for primary screening.ConclusionsLead-time bias, usually causing an overestimation of screening effectiveness, is an elementary and fundamental issue in cancer screening. Quantification and correction of lead-time bias are essential when evaluating the effectiveness of endoscopic screening in the high-risk area in China.

The Japanese Breast Cancer Society Clinical Practice Guidelines for Breast Cancer Screening and Diagnosis, 2018 Edition

This article updates readers as to what is new in the Japanese Breast Cancer Society Clinical Practice Guidelines for Breast Cancer Screening and Diagnosis, 2018 Edition. Breast cancer screening issues are covered, including matters of breast density and possible supplemental modalities, along with appropriate pre-operative/follow-up diagnostic breast imaging tests. Up-to-date clinical practice guidelines for breast cancer screening and diagnosis should help to provide patients and clinicians with not only evidence-based breast imaging options, but also accurate and balanced information about the benefits and harms of intervention, which ultimately enables shared decision making about imaging test plans.

Cancer screening in the United States, 2019: A review of current American Cancer Society guidelines and current issues in cancer screening.

Each year, the American Cancer Society publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, the current American Cancer Society cancer screening guidelines are summarized, and the most current data from the National Health Interview Survey are provided on the utilization of cancer screening for men and women and on the adherence of men and women to multiple recommended screening tests.

Cancer screening in the United States, 2018: A review of current American Cancer Society guidelines and current issues in cancer screening.

Each year, the American Cancer Society publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates from the National Health Interview Survey, and select issues related to cancer screening. In this 2018 update, we also summarize the new American Cancer Society colorectal cancer screening guideline and include a clarification in the language of the 2013 lung cancer screening guideline. CA Cancer J Clin 2018;68:297-316. © 2018 American Cancer Society.

Cancer Screening and Early Detection in Older People: Considerations for Nursing Practice.

To synthesize relevant issues in cancer screening for older people for nursing practice. Published scientific literature, clinical literature, and published cancer screening guidelines from the United States and Canada. Nurses are caring for increasing numbers of older patients and, with this demographic shift, face increasing demands to address cancer screening and detection in both primary and specialty practice. Ageism, self-stereotyping, cancer fear and fatalism, and cancer survivorship experiences influence cancer screening and generate the need for improved awareness of these issues to advance nursing practice.

Cancer screening in the United States, 2017: A review of current American Cancer Society guidelines and current issues in cancer screening.

Answer questions and earn CME/CNE Each year, the American Cancer Society publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, the authors summarize current American Cancer Society cancer screening guidelines, describe an update of their guideline for using human papillomavirus vaccination for cancer prevention, describe updates in US Preventive Services Task Force recommendations for breast and colorectal cancer screening, discuss interim findings from the UK Collaborative Trial on Ovarian Cancer Screening, and provide the latest data on utilization of cancer screening from the National Health Interview Survey. CA Cancer J Clin 2017;67:100-121. © 2017 American Cancer Society.

Abstract IA41: Emerging Issues in Cancer Screening for Racial and Ethnic Minorities

Abstract Cancer screening plays an important role in early detection; detecting cancer in an early stage has important implications for cancer health disparities. Considerable efforts have been made to increase access to early detection services among racial and ethnic minorities in order to improve cancer outcomes in these populations. However, our recent work has shown that racial disparities in cancer screening continue to exist. For instance, about 40% of women in our national random survey of cultural considerations in cancer screening were not up-to-date with mammography guidelines. Our other work with a community-based sample of African American men demonstrated that informed decision-making about PSA testing may be low. Fifty-seven percent of men reported having a PSA test during the past year, but none of the variables that are important to informed decision-making were associated with having annual screening. With respect to lung cancer screening, our recent qualitative research demonstrated that patients have limited discussions with providers about the benefits and limitations of lung cancer screening and had difficulty recalling receipt of information about screening, even though many decided to have low dose computed tomography (LDCT). This may be because of limited knowledge about screening guidelines and low enthusiasm and commitment to LCDT among providers. Providers relied on clinical reminders from the electronic health system to remind them to assess patients for eligibility for LDCT and offer screening. Provider referral to smoking cessation programs was also limited. Provider referral to smoking cessation programs, and delivery of this service, is especially important among high-risk smokers who are candidates for LCDT. Using data from the National Lung Screening Trial (NLST), our research demonstrated that current smokers have an increased risk of lung cancer and all-cause mortality compared to former smokers regardless of randomization to LCDT or the control condition. In addition, smoking abstinence for seven years was associated with a 20% reduction in lung cancer mortality among those screened with chest radiograph. Screening with LCDT and smoking abstinence for 15 years had the greatest mortality risk reduction. African Americans were under-represented in the NLST; therefore, greater efforts are needed to disseminate and implement lung cancer screening in more diverse health care facilities. Citation Format: Chanita Hughes Halbert. Emerging Issues in Cancer Screening for Racial and Ethnic Minorities. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr IA41.

PSA testing for men at average risk of prostate cancer.

Prostate-specific antigen (PSA) testing of men at normal risk of prostate cancer is one of the most contested issues in cancer screening. There is no formal screening program, but testing is common - arguably a practice that ran ahead of the evidence. Public and professional communication about PSA screening has been highly varied and potentially confusing for practitioners and patients alike. There has been much research and policy activity relating to PSA testing in recent years. Landmark randomised controlled trials have been reported; authorities - including the 2013 Prostate Cancer World Congress, the Prostate Cancer Foundation of Australia, Cancer Council Australia, and the National Health and Medical Research Council - have made or endorsed public statements and/or issued clinical practice guidelines; and the US Preventive Services Task Force is revising its recommendations. But disagreement continues. The contention is partly over what the new evidence means. It is also a result of different valuing and prioritisation of outcomes that are hard to compare: prostate cancer deaths prevented (a small and disputed number); prevention of metastatic disease (somewhat more common); and side-effects of treatment such as incontinence, impotence and bowel trouble (more common again). A sizeable proportion of men diagnosed through PSA testing (somewhere between 20% and 50%) would never have had prostate cancer symptoms sufficient to prompt investigation; many of these men are older, with competing comorbidities. It is a complex picture. Below are four viewpoints from expert participants in the evolving debate, commissioned for this cancer screening themed issue of Public Health Research & Practice. We asked the authors to respond to the challenge of PSA testing of asymptomatic, normal-risk men. They raise important considerations: uncertainty, harms, the trustworthiness and interpretation of the evidence, cost (e.g. of using multiparametric magnetic resonance imaging to triage patients with elevated PSA), a likely bias towards intervention (particularly for cancer), and the potential to limit harm by treating more conservatively (although this may not occur consistently). They provide important insights, and disagree on some issues, but generally concur that men should decide for themselves whether to be tested. It seems reasonable to support men's autonomy to make their own decisions based on their own values. However, the support men might require to decide is likely to be considerable, and this needs to be taken seriously in policy making.

OP108 Health Intervention Assessment Report Adaptation: Tunisian Experience

INTRODUCTION:Health Technology Assessment (HTA) reports adaptation process is an important tool for emerging HTA agencies. INASanté (National Instance for Accreditation in Healthcare) has chosen to rely on this approach, to develop its first health intervention assessment report: comparative study of computed tomographic colonography versus standard colonoscopy for colorectal cancer screening.METHODS:Following consultations with healthcare professionals, the PICO question related to the colorectal cancer screening issue in Tunisia was determined. A literature search strategy covering 10 years (2006-2016) was carried out. Several databases including HTA on the net were explored. Then two independent reviewers conducted literature screening and realized a PRISMA flow diagram. Full text selected reports were submitted to three critical appraisal tools: PRISMA checklist, INAHTA checklist and Critical Appraisal Tools (FLC 2.0). The EUnetHTA adaptation toolkit was used to determine reports adaptability by assessing relevance, reliability and transferability. A structured study of the Tunisian context based on a qualitative data analysis was elaborated. The data synthesis and reporting were finalized with the contribution of a working group. Then an external peer review was conducted before the report dissemination.RESULTS:Eighty reports were screened to finally retain four eligible. After a critical appraisal performed by two independent reviewers, two reports from the Canadian Agency for Drug and Technolgies in Healthcare and AETSA were selected to be assessed using the EUnetHTA adaptation toolkit. Regarding transferability criteria, the second report was retained. The context study has consisted in a qualitative analysis of seventeen individual interviews with healthcare professionals involved in colorectal cancer screening issues and an up to date Tunisian literature review. The final adapted report was a combination between relevant extracted data from AETSA report and synthesis of the Tunisian context analysis.CONCLUSIONS:This HTA report represents a tool for policy makers to establish the appropriate colorectal cancer screening program for the Tunisian context. HTA reports adaptation process is the best way to give evidence on emerging technologies without wasting time and resources.

Evaluation of an Electronic Consultation Service in Obstetrics and Gynecology in Ontario

To describe the effectiveness of an electronic consultation (eConsult) service by examining the number of traditional referrals that were avoided as a result of the service, to characterize the type and content of the clinical questions being asked, and to describe the time required for the specialist to complete each eConsult. This is a retrospective electronic chart review study. All eConsults directed to obstetrics and gynecology from July 2011 to January 2015 were reviewed. Each eConsult was categorized by clinical topic and question type in predetermined categories. Mandatory post-eConsult surveys for primary care providers were analyzed to determine the number of traditional consults avoided and to gain insight into the perceived value of eConsults. The amount of time reported by the specialist to answer each eConsult was analyzed. A total of 394 of 5,597 eConsults were directed to obstetrics and gynecology (7.0%). In 34.3% of eConsults, primary care providers indicated that a traditional consult was avoided. Pregnancy issues and gynecologic cancer screening issues were the most common queries. Primary care providers highly valued the eConsult and the majority of eConsults were completed within 15 minutes (98.8%). Electronic consultations were effective at reducing the number of traditional consults requested over 3.5 years. This initiative has potential to reduce current wait times for traditional consultation in Canada and to make the consultation process more effective. The service was feasible and well-received by primary care providers.

Cancer screening in the United States, 2016: A review of current American Cancer Society guidelines and current issues in cancer screening.

Each year the American Cancer Society (ACS) publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, we summarize current ACS cancer screening guidelines, including the update of the breast cancer screening guideline, discuss quality issues in colorectal cancer screening and new developments in lung cancer screening, and provide the latest data on utilization of cancer screening from the National Health Interview Survey.

Cancer screening in the United States, 2015: a review of current American cancer society guidelines and current issues in cancer screening.

Each year, the American Cancer Society (ACS) publishes a summary of its guidelines for early cancer detection along with a report on data and trends in cancer screening rates and select issues related to cancer screening. In this issue of the journal, we summarize current ACS cancer screening guidelines. The latest data on utilization of cancer screening from the National Health Interview Survey (NHIS) also is described, as are several issues related to screening coverage under the Affordable Care Act, including the expansion of the Medicaid program.

Cancer screening in the United States, 2014: A review of current American Cancer Society guidelines and current issues in cancer screening

Answer questions and earn CME/CNE Each year the American Cancer Society publishes a summary of its guidelines for early cancer detection, a report on data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, we summarize current American Cancer Society cancer screening guidelines. In addition, the latest data on the use of cancer screening from the National Health Interview Survey is described, as are several issues related to screening coverage under the Patient Protection and Affordable Care Act, including the expansion of the Medicaid program.

Discussing uncertainty and risk in primary care: recommendations of a multi-disciplinary panel regarding communication around prostate cancer screening.

BACKGROUNDShared decision making improves value-concordant decision-making around prostate cancer screening (PrCS). Yet, PrCS discussions remain complex, challenging and often emotional for physicians and average-risk men.OBJECTIVEIn July 2011, the Centers for Disease Control and Prevention convened a multidisciplinary expert panel to identify priorities for funding agencies and development groups to promote evidence-based, value-concordant decisions between men at average risk for prostate cancer and their physicians.DESIGNTwo-day multidisciplinary expert panel in Atlanta, Georgia, with structured discussions and formal consensus processes.PARTICIPANTSSixteen panelists represented diverse specialties (primary care, medical oncology, urology), disciplines (sociology, communication, medical education, clinical epidemiology) and market sectors (patient advocacy groups, Federal funding agencies, guideline-development organizations).MAIN MEASURESPanelists used guiding interactional and evaluation models to identify and rate strategies that might improve PrCS discussions and decisions for physicians, patients and health systems/society. Efficacy was defined as the likelihood of each strategy to impact outcomes. Effort was defined as the relative amount of effort to develop, implement and sustain the strategy. Each strategy was rated (1–7 scale; 7 = maximum) using group process software (ThinkTankTM). For each group, intervention strategies were grouped as financial/regulatory, educational, communication or attitudinal levers. For each strategy, barriers were identified.KEY RESULTSHighly ranked strategies to improve value-concordant shared decision-making (SDM) included: changing outpatient clinic visit reimbursement to reward SDM; development of evidence-based, technology-assisted, point-of-service tools for physicians and patients; reframing confusing prostate cancer screening messages; providing pre-visit decision support interventions; utilizing electronic health records to promote benchmarking/best practices; providing additional training for physicians around value-concordant decision-making; and using re-accreditation to promote training.CONCLUSIONSConference outcomes present an expert consensus of strategies likely to improve value-concordant prostate cancer screening decisions. In addition, the methodology used to obtain agreement provides a model of successful collaboration around this and future controversial cancer screening issues, which may be of interest to funding agencies, educators and policy makers.Electronic supplementary materialThe online version of this article (doi:10.1007/s11606-013-2419-z) contains supplementary material, which is available to authorized users.

Ethical Issues in Cancer Screening and Prevention

November 2009's announcement of the USPSTF's recommendations for screening for breast cancer raised a firestorm of objections. Chief among them were that the panel had insufficiently valued patients' lives or allowed cost considerations to influence recommendations. The publicity about the recommendations, however, often either simplified the actual content of the recommendations or bypassed significant methodological issues, which a philosophical examination of both the science behind screening recommendations and their import reveals. In this article, I discuss two of the leading ethical considerations at issue in screening recommendations: respect for patient autonomy and beneficence and then turn to the most significant methodological issues raised by cancer screening: the potential biases that may infect a trial of screening effectiveness, the problem of base rates in communicating risk, and the trade-offs involved in a judgment of screening effectiveness. These issues reach more broadly, into the use of "evidence-based" medicine generally, and have important implications for informed consent.

Abstract CN05-05: Decision making in prostate cancer screening

Abstract Background: Prostate cancer (PCa) is the leading cancer diagnosis among men and the second leading cause of male cancer death. However, screening asymptomatic men remains controversial, as early diagnosis and treatment of PCa has not yet been definitively demonstrated to reduce disease-related mortality in a randomized trial. The primary question is whether PCa screening results in overdiagnosis, the detection and treatment of disease that would not otherwise result in increased morbidity or mortality. Ongoing trials are addressing this question, but the final results will not be available for several years. Further, if the trials do not provide a definitive recommendation for or against screening, the question will persist. The difficulty of making medical decisions prior to the availability of definitive outcome data has been a long-standing issue in cancer screening and is likely to become increasingly important as screening technology advances more rapidly than our ability to validate it. Thus, widely applicable approaches to health education are needed in order to facilitate informed decision making about the growing number of unproven treatment and screening technologies, of which PCa screening is a prime example. Despite the PCa screening controversy, the practice of screening asymptomatic men is increasing in the U.S. and men are increasingly committed to screening. Most men who undergo PCa screening are unaware of the controversy and believe that the medical community unequivocally accepts the benefits of screening. One approach to improving informed consent for PCa screening is the development, evaluation, and dissemination of patient education materials and decision aids. Abundant evidence documents the expanding role of the Internet in increasing access to and understanding of health information. However, systematic evaluations of Internet-based interventions are needed to address questions regarding the accessibility and efficacy of this mode of health education, particularly among older adults, persons without a college education, and minority participants. We conducted a randomized clinical trial to test the effectiveness of widely accessible and disseminable methods to assist men in making informed decisions about PCa screening. The goal of this research program is neither to encourage nor discourage PCa screening, but instead is designed to assist patients in making an informed decision until the definitive data on screening effectiveness are available. Method: This study included male outpatients aged 45 to 70 from two Washington, DC, area hospitals and an outpatient group practice (N = 1,893). Trial arms included: 1) print-based information and a decision aid (Print; N = 630), 2) web-based information plus an interactive decision aid (Web; N = 631), and 3) usual care (UC; N = 632). Subjects completed outcome assessments at baseline, one- and 13-months post-baseline. The primary outcomes of interest were knowledge, decisional conflict, decisional satisfaction, health-related quality of life, screening preferences, screening intentions, and screening behavior. Results: Participants were a mean age of 57, 40% were African American, and 70% had been screened for PCa within 12 months prior to the baseline assessment. We assessed the short-term (1-month) impact of the educational interventions on knowledge, decisional conflict, and decisional satisfaction. Multivariate analyses revealed a significant improvement in knowledge for the print and Web groups at the one-month assessment in comparison to the UC group (F (2,1630) = 119.4, p = .000). Regarding decisional conflict, the Web (OR = .449 (.341, .591)) and print (OR = .464 (.352, .611)) arms were less likely than the UC group to report high decisional conflict at the 1-month follow-up. There was no significant impact on satisfaction with the screening decision between the three study groups. We will also present findings on the short-term impact of the interventions on screening preferences and screening intentions, as well as the long-term (13-months) impact on prostate cancer screening behavior. Conclusions: Both the Print- and Web-based tools significantly impacted short-term outcomes by increasing knowledge and reducing decisional conflict relative to the UC arm. However, contrary to prediction, there were no group differences in decisional satisfaction. This was likely due to a ceiling effect, as all groups reported a very high level of decisional satisfaction at both assessments. We have developed and tested two methods of patient education that are easily disseminable in real-world settings. These methods are effective and could improve clinical care by providing an easily adaptable way to provide patients with the information needed to assist them in making an informed decision about PCa screening. The next step of this research is to conduct a dissemination trial to determine the most cost-effective method of educating large groups of men about PCa screening so that they may make the best screening decision for themselves, until there is a definitive recommendation either for or against screening. Citation Information: Cancer Prev Res 2010;3(12 Suppl):CN05-05.