Group Talks Help Men Decide On Prostate Screening

Many men are not aware of the pros and cons of taking a prostate cancer test and do not make informed decisions. Now, new research suggests that health officials can help men choose more wisely by making presentations to them in groups in their communities.

Researchers found that they could boost levels of "informed decision-making" and encourage consultation with doctors by speaking at places like churches, YMCAs and barbershops.

"It allows us to reach residents who wouldn't normally receive these interventions in clinical settings. They were able to learn about an important decision," said lead study author David Driscoll, a senior medical anthropologist with the RTI International research firm.

Medical officials often advise men over 50 to think carefully about taking blood tests that detect the presence of prostate tumors. The problem is that the prostate-specific antigen (PSA) tests can't tell whether the tumors are actually dangerous, Driscoll said.

The jury is still out over whether prostate-cancer screening of men without symptoms will save lives, said Dominick Frosch, an assistant professor of medicine at the University of California at Los Angeles.

"Treatments for prostate cancer often have some forms of side effects and, in many cases they're permanent, like impotence or incontinence," said RTI's Driscoll. "(Men) have to decide whether getting tested is in their best interest, and it's a decision they have to make for themselves."

Driscoll and colleagues developed two different educational strategies regarding PSA tests and tried them out in 2004 and 2005 on groups of wealthy and poor men -- 361 men altogether -- in Greensboro and Wilmington, N.C. Their findings appear in the August issue of the American Journal of Preventive Medicine.

One approach included information about PSA tests as part of an overall program looking at a variety of health issues. The other approach emphasized PSA tests specifically.

Both approaches included videos of men -- "peer role models" -- who spoke about the decisions they made about whether to be tested. A team of health specialists talked about the test to the groups, which ranged in size from 10 to 32.

"There would usually be a wide-ranging discussion, in many cases of people who knew each other for a long period of time," Driscoll said.

Overall, men who watched presentations of both types became more likely to want to take an active role in decisions about prostate-cancer testing, Driscoll said. While the intent of the presentations was not to support or discourage PSA testing, the percentage of men who wanted the tests dropped from 70 percent before the presentations to 56 percent a year later.

The study is "very valuable," said Frosch, who studies how patients make decisions about prostate cancer tests. "What they've demonstrated is that there are alternative ways to help health care consumers make informed decisions about the kind of care they receive."