Background: Little is known about what information affects men's decisions about prostate cancer screening.
Methods: We developed a four-part decision aid about prostate cancer screening and tested it in men, ages 45-85, to determine how the information in each part--(1) the epidemiology of prostate cancer; (2) the PSA test; (3) prostate biopsy and treatment options for prostate cancer; and (4) balance sheets to aid decision-making--affected men's interest in screening.
Results: One hundred eighty-eight men from one general internal medicine clinic participated in our study (response rate 65%). Before the decision aid, 76% were interested in screening; 8% were not; and 16% were undecided. The decision aid increased the proportion of men who knew the advantages (+28%; 95% CI: 21-35) and disadvantages (+55%; 95% CI: 48-63%) of screening. It also increased the proportion who knew enough to make a decision (+24; 95% CI: 16-32%). It did not change men's interest in screening (P = 0.134). Twenty percent of men, however, did change their interest category. Men who were undecided at baseline were more likely to change than those who were interested or not interested. There were no clinically meaningful changes in interest following each component part of the decision aid.
Conclusion: Interest in prostate cancer screening is high and remained high after a 10 min decision aid. The decision aid increased the proportion of men with sufficient information to decide about screening. It also changed 20% of men's interest in screening. Because no single piece of information was influential to decision-making in all men, clinicians may want to tailor information to men's individual needs.
Copyright 2004 Elsevier Ireland Ltd.