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Physicians Are Inconsistent When it Comes to Informed Decision-Making for PSA Testing

 
MONDAY, Jan. 21 (HealthDay News) -- Physicians' practice styles related to informed decision-making for prostate-specific antigen (PSA) screening are linked to their personal beliefs about screening, according to a study published in the January/February issue of the Annals of Family Medicine.

Robert J. Volk, Ph.D., from the University of Texas MD Anderson Cancer Center in Houston, and colleagues surveyed 246 family physicians regarding their prescreening discussions about the potential harms and benefits of prostate cancer screening, and their beliefs regarding screening.

The researchers found that 24.3 percent of physicians ordered screening without discussion. Physicians who discussed harms and benefits with patients and then let them decide (47.7 percent) were more likely to believe that scientific evidence does not support screening. They were also more likely to believe that patients should be alerted to the lack of evidence, and have a right to know the limitations of screening. They were less likely to support the belief that educating patients was not necessary because they wanted to be screened. Physicians who discussed the harms and benefits and recommended screening were more concerned about medicolegal risk associated with not screening, compared with physicians who discussed screening and let their patients decide.

"As the scientific evidence continues to grow regarding the limited benefits of screening with PSA testing and practice guidelines more strongly recommend preference-based decision making, we may expect physicians who do not engage their patients in discussions about the potential harms and benefits of screening to consider changing their practice styles," the authors write. "Efforts to educate physicians about the shared decision-making process should include countering the beliefs that perpetuate routine screening."
 

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Further Reading
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Compared with placebo, saw palmetto, even at a dose as high as 960 mg, does not affect serum prostate-specific antigen levels in men with lower urinary tract symptoms, according to research published in the February issue of The Journal of Urology.
Discussion of prostate-specific antigen screening should focus on current guidelines and emphasize shared decision making, according to an article published Feb. 11 in the Urology Times.
Researchers at New York-Presbyterian Hospital/Weill Cornell Medical Center have devised a new approach for detecting risk of aggressive prostate cancer, while avoiding unnecessary biopsies.
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In a two-year, observational follow-up study of the four-year REduction by DUtasteride of prostate Cancer Events clinical study, men demonstrated a low rate of new prostate cancer diagnoses, although those men who had been treated with the 5α-reductase inhibitor dutasteride exhibited twice as many prostate cancers compared with placebo-treated men, according to research published in the March issue of The Journal of Urology.
If you had prostate cancer, would you want to know? Consider this: prostate cancer grows slowly, and in many cases, undetected tumors never become life threatening.
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