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

Hussein Saad Amin; Mostafafa Ahmed Arafa; Karim Hamda Farhat; Danny Munther Rabah; Abdulaziz Abdullah Altaweel; Abdulaziz Hamed Alhammad

doi:10.4314/ahs.v20i4.43

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

Afr Health Sci. 2020 Dec;20(4):1870-1874. doi: 10.4314/ahs.v20i4.43.

Authors

Hussein Saad Amin¹, Mostafafa Ahmed Arafa², Karim Hamda Farhat², Danny Munther Rabah^{2

3}, Abdulaziz Abdullah Altaweel⁴, Abdulaziz Hamed Alhammad⁴

Affiliations

¹ Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
² Cancer Research Chair, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
³ Surgery Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
⁴ Medical Intern, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Abstract

Background: Men over 50 should discuss the benefits and harms of prostate-specific antigen (PSA) testing with their doctors.

Objectives: To investigate whether shared decision making (SDM) increases the uptake of prostate cancer screening practices among Saudi men.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Decision making; low prevalence countries; prostate cancer screening.

MeSH terms

Aged
Aged, 80 and over
Decision Making, Shared*
Early Detection of Cancer / statistics & numerical data*
Humans
Male
Mass Screening / statistics & numerical data*
Middle Aged
Patient Participation
Physicians / psychology*
Practice Patterns, Physicians'
Prevalence
Prostatic Neoplasms / diagnosis*
Prostatic Neoplasms / epidemiology
Prostatic Neoplasms / prevention & control*
Referral and Consultation
Surveys and Questionnaires