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PSA Test Often Occurs Without Discussion of Benefits, Harms

WEDNESDAY, April 12, 2017 -- Fewer than one in three men screened with the prostate-specific antigen (PSA) test for prostate cancer talked about the risks and benefits of the test with their doctor, according to a study published online recently in Urology.

Before the 2012 U.S. Preventive Services Task Force (USPSTF) recommendation was made, a survey conducted that same year found that only 30.1 percent of patients had discussed both the risks and benefits of PSA testing with their doctor. Slightly more -- 30.5 percent -- said they had no discussion about these issues, 38.5 percent only talked about the advantages of PSA testing, and 0.8 percent discussed only the disadvantages.

Two years later, a survey of 111,241 men found little change --- only 29.5 percent reported discussing both the pros and cons of PSA testing. Another 33.9 percent had no discussion at all about risks or benefits, and 35.7 percent of men talked with their doctors only about the benefits of screening. In 2012, 63.0 percent of men underwent PSA tests. In 2014, that number decreased slightly, to 62.4 percent, the researchers found. Men who were more likely to undergo testing without being aware of all the risks and benefits involved had low incomes, lacked a high school diploma, were uninsured, or were Hispanic.

"We believe our findings may be indicative of a shift in practice patterns away from detailed prescreening discussions among health care providers who have implemented the 2012 (USPSTF) recommendation into their caregiving," the authors write.

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Posted: April 2017