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Men and Doctors are still not having the Discussion on the PSA test

Update Date: Jul 12, 2013 11:19 AM EDT
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The PSA, prostate-specific antigen, test is one of just two tests that are currently available to screen men for prostate cancer with the other being a digital rectal exam. Since prostate cancer is usually curable when diagnosed early, a lot of men opt to get PSA tested. However, PSA tests could influence men to undergo surgery or medical treatment that might not be necessary. Doctors have found that close monitoring using a wait-and-see approach could help men avoid these life-altering treatments that could lead to impotence. Doctors from the American Urologist Association have stressed the importance of discussing the pros and cons of getting a PSA test even though two studies reveal that the discussions are still not happening.

Ideally, patients should be a part of the shared decision making process in order to determine the best route for them. By discussing the individual health risks and desires, doctors can help each person create a unique route in tackling prostate cancer, whether or not it has manifested. In a previous survey headed by researchers from the Maine Medical Center Research Institute, they found that doctors did not ask their patients about the PSA test. According to over 3,000 surveyed men aged 50 to 74, around two-thirds of them stated that they never had a conversion with their doctors about the benefits, risks and scientific uncertainty of the PSA test. The researchers found that more educated men tended to get more screenings and were more likely to talk about the PSA test with their doctors. This survey was published in the Annals of Family Medicine.

Based from the survey results, researchers conducted two studies to see if they could train doctors to be better at having the PSA test conversation. In the first study, researchers recruited 120 physicians. Half of the physicians were randomly assigned to receive training in the shared decision making process. The researchers then asked actors to pretend to be patients and ask about the PSA test. The researchers found that trained physicians were only slightly more likely to discuss the PSA test in depth with the patients. The patients were then more likely to report that not getting screen was an option. Most men believe that getting screen is recommended.  

In the other study, researchers administered another type of training to get the physicians to talk about the PSA test. Some of the doctors were also prompted by actor-patients to talk about the PSA test. In this study, the researchers found that there were no differences between the trained doctors and the untrained ones.

The studies were conducted by the University of California Davis School of Medicine and suggests that more doctors and patients need to start discussing the PSA test. They were both published in the Annals of Family Medicine.

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