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. 2018 Jun 28:8:238.
doi: 10.3389/fonc.2018.00238. eCollection 2018.

Testing of a Tool for Prostate Cancer Screening Discussions in Primary Care

Anita D Misra-Hebert  1   2   3 , Grant Hom  4 , Eric A Klein  5 , Janine M Bauman  3 , Niyati Gupta  2 , Xinge Ji  3 , Andrew J Stephenson  5 , J Stephen Jones  5 , Michael W Kattan  3
Affiliations

Testing of a Tool for Prostate Cancer Screening Discussions in Primary Care

Anita D Misra-Hebert et al. Front Oncol. .

Abstract

Background: As prostate cancer (PCa) screening decisions often occur in outpatient primary care, a brief tool to help the PCa screening conversation in busy clinic settings is needed.

Methods: A previously created 9-item tool to aid PCa screening discussions was tested in five diverse primary care clinics. Fifteen providers were recruited to use the tool for 4 weeks, and the tool was revised based upon feedback. The providers then used the tool with a convenience sample of patients during routine clinic visits. Pre- and post-visit surveys were administered to assess patients' knowledge of the option to be screened for PCa and of specific factors to consider in the decision. McNemar's and Stuart-Maxwell tests were used to compare pre-and post-survey responses.

Results: 14 of 15 providers completed feedback surveys and had positive responses to the tool. All 15 providers then tested the tool on 95 men aged 40-69 at the five clinics with 2-10 patients each. The proportion of patients who strongly agreed that they had the option to choose to screen for PCa increased from 57 to 72% (p = 0.018) from the pre- to post-survey, that there are factors in the personal or family history that may affect PCa risk from 34 to 47% (p = 0.012), and that their opinions about possible side effects of treatment for PCa should be considered in the decision from 47 to 61% (p = 0.009).

Conclusion: A brief conversation tool for the PCa screening discussion was well received in busy primary-care settings and improved patients' knowledge about the screening decision.

Keywords: cancer screening; clinical decision-making; prostate cancer; prostate-specific antigen; shared decision-making.

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Figures

Figure 1
Figure 1
Count distribution of individual question responses for questions 1–9 (A–I) and total score on prostate cancer screening conversation tool.
Figure 1
Figure 1
Count distribution of individual question responses for questions 1–9 (A–I) and total score on prostate cancer screening conversation tool.
See this image and copyright information in PMC

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