Melina Gattellari1, Jeanette E Ward. 1. Department of General Practice, School of Public Health and Community Medicine, University of New South Wales, Liverpool, Australia. Melina.Gattellari@swsahs.nsw.gov.au
Abstract
OBJECTIVE: We explored the influence of different but factual scenarios about prostate-specific antigen (PSA) screening on men's interest in having PSA screening to detect early prostate cancer. DESIGN: Cross-sectional, representative community survey. SETTING AND PARTICIPANTS: A total of 514 men (89% response fraction) aged 50-70 years randomly selected from a telephone directory database in Sydney, Australia. MAIN VARIABLES STUDIED: Demographic, health and psychological variables. MAIN OUTCOME VARIABLES: Interest in undergoing screening in response to five unspecified scenarios and, elsewhere in our interview, a specified scenario in which PSA screening was mentioned explicitly. RESULTS: When presented with a scenario describing a lack of evidence underpinning the efficacy of screening for an unspecified cancer, 61.2% of men reported that they 'probably' or 'definitely' wanted to undergo screening for an unspecified cancer. Similar proportions reported that they 'probably' or 'definitely' wanted to undergo screening even at the risk of unmasking indolent cancer (60.9%) or without expert consensus about the value of screening (62.8%). Greatest interest in screening was elicited in that scenario describing life-time risk of dying from prostate cancer (72.6%) (P < 0.001). Significantly fewer indicated they would 'probably' or 'definitely' want to undergo screening for a cancer for which there was uncertainty about treatment efficacy and known side-effects (46.1%) (P < 0.001). Increasing age was a consistent predictor of positive interest in screening. When asked later in our survey specifically about PSA screening, 68.1%'probably' or definitely' wanted PSA screening. CONCLUSION: Public health policy makers need to ensure that men are provided with the scope of medical evidence germane to prostate cancer screening and treatment, thereby potentially improving prostate cancer screening decisions.
OBJECTIVE: We explored the influence of different but factual scenarios about prostate-specific antigen (PSA) screening on men's interest in having PSA screening to detect early prostate cancer. DESIGN: Cross-sectional, representative community survey. SETTING AND PARTICIPANTS: A total of 514 men (89% response fraction) aged 50-70 years randomly selected from a telephone directory database in Sydney, Australia. MAIN VARIABLES STUDIED: Demographic, health and psychological variables. MAIN OUTCOME VARIABLES: Interest in undergoing screening in response to five unspecified scenarios and, elsewhere in our interview, a specified scenario in which PSA screening was mentioned explicitly. RESULTS: When presented with a scenario describing a lack of evidence underpinning the efficacy of screening for an unspecifiedcancer, 61.2% of men reported that they 'probably' or 'definitely' wanted to undergo screening for an unspecifiedcancer. Similar proportions reported that they 'probably' or 'definitely' wanted to undergo screening even at the risk of unmasking indolent cancer (60.9%) or without expert consensus about the value of screening (62.8%). Greatest interest in screening was elicited in that scenario describing life-time risk of dying from prostate cancer (72.6%) (P < 0.001). Significantly fewer indicated they would 'probably' or 'definitely' want to undergo screening for a cancer for which there was uncertainty about treatment efficacy and known side-effects (46.1%) (P < 0.001). Increasing age was a consistent predictor of positive interest in screening. When asked later in our survey specifically about PSA screening, 68.1%'probably' or definitely' wanted PSA screening. CONCLUSION: Public health policy makers need to ensure that men are provided with the scope of medical evidence germane to prostate cancer screening and treatment, thereby potentially improving prostate cancer screening decisions.
Authors: Heather M Davey; Alexandra L Barratt; Elizabeth Davey; Phyllis N Butow; Sally Redman; Nehmat Houssami; Glenn P Salkeld Journal: Health Expect Date: 2002-12 Impact factor: 3.377
Authors: W Rakowski; M R Andersen; A M Stoddard; N Urban; B K Rimer; D S Lane; S A Fox; M E Costanza Journal: Health Psychol Date: 1997-09 Impact factor: 4.267