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RTIPs Meet-up: Prostate Cancer Screening: Making the Best Decision

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We are so very delighted to post the most recent Research-tested Intervention Program (RTIP), "Prostate Cancer Screening: Making the Right Decision". This program is so very timely and we hope you will find it valuable. While screening tests for prostate cancer are available, screening may not be appropriate for all men for a number of reasons.

  • First, because most forms of prostate cancer grow slowly (or not at all), they often do not cause any health problems. Consequently, screening will not help all men with prostate cancer live longer.
  • Second, no single standard screening test exists for prostate cancer, and the tests available have limitations and sometimes provide inaccurate results. When results appear to be normal but cancer is present (a false-negative test result), a patient may delay seeking medical care even if he has symptoms. When results show cancer is present but it is not (a false-positive test result), a patient may experience anxiety and unnecessarily undergo additional tests.
  • Furthermore, there are risks associated with follow-up tests and treatment. Should a patient undergo a biopsy as a follow-up to screening, he may experience fever, pain, bleeding, and infection.  The treatments for prostate cancer may cause serious side effects, such as urinary, bowel, and sexual problems. 

Because of concerns about the benefits of screening relative to the risks, the U.S. Preventive Services Task Force recommends against routinely screening asymptomatic men, leaving the decision to patients and their doctors, while other medical organizations offer conflicting recommendations about screening some or all men over age 40. Prostate Cancer Screening: Making the Right Decision is a self-guided, web-based decision aid to help men aged 50–70 decide whether to undergo prostate cancer screening. The intervention aims to increase knowledge on prostate cancer and the risks and benefits of screening, reduce the uncertainty or decisional conflict associated with making a choice about screening, and increase satisfaction with that choice, with the hope that men will make the best decision for themselves. 

Eligible men are identified for participation by their health care provider or a community organization and receive information on the intervention (including the web address) in person or by mail. The six sections of the decision aid include introductory material about the prostate gland, a description of screening options and their benefits and limitations, a review of treatment options (e.g., early treatment, watchful waiting) and their risks and benefits, a review of prostate cancer risk factors and the importance of making a decision in conjunction with a doctor, a 10-item values clarification tool to help the user assess his own preferences, and resources for more information (e.g., sources for statistics and research, national organizations that can provide more information about prostate cancer screening and shared decision making that includes the patient and doctor). The decision aid stresses that there is no right or wrong decision about whether to undergo screening; each man needs to make a decision for himself based on available evidence and his own preferences. 

We invite you to learn more about this new tool and perhaps more importantly, let us know your thoughts, your questions and your concerns.