Prostate Cancer Screening: A Shared Decision
The Massachusetts Department of Public Health (MDPH) convened a Prostate Cancer Workgroup in 2013 to provide balanced information about prostate cancer screening for men and for health care providers. The workgroup is comprised of providers, researchers, and advocates and is one of the many workgroups in the Massachusetts Comprehensive Cancer Prevention and Control Network (MCCPCN).
In 2013, the University of Massachusetts Medical School received a Patient-Centered Outcomes Research Institute grant to develop prostate cancer screening guidelines specific to Massachusetts. These guidelines promote the use of shared decision making when discussing prostate cancer screening. The guidelines were adopted by the Massachusetts Health Quality Partners (MHQP), and are consistent with those issued by American Cancer Society, the American Urological Association, the American College of Physicians, and the American Academy of Family Physicians.
In support of these guidelines, the workgroup created decision aid tools to help facilitate shared decision making making conversations between men and their providers. The tools were tested and piloted in 2015.
Decision Aids from the Prostate Cancer Workgroup
Literature reviews on shared decision making and decision making aids were conducted to ensure validity of the decision aid tools. The tools provide information for patients on the options, outcomes, benefits, and harms in a clear concise manner. The tools also highlight multiple decision points along the prostate cancer screening process, noting the benefits and harms associated with each decision.
Patients and their providers can review the decision aids together during a patient visit, and/or a patient can review them at home. They are available in English, Spanish, Portuguese, and Haitian Creole. View the fact sheets and decision aids.
Order the decision aids for free from the Massachusetts Health Promotion Clearinghouse.
Integrating Shared Decision Making
According to the Informed Medical Decisions Foundation, shared decision making is a collaborative process in which patients and providers make health care decisions together, taking into account the provider’s knowledge, the scientific evidence available, and the patient’s values and preferences.
In shared decision making, patients participate, while providers present options; communicate the benefits and harms; help the patient evaluate the options based on their goals, values and concerns; and then facilitate the decision with the patient.
Videos Showing Shared Decision Making in Prostate Cancer Screening
The Prostate Cancer Workgroup convened by MDPH developed two videos that demonstrate a patient and primary care provider engaged in shared decision making around prostate cancer screening. The videos provide an example of a patient/provider interaction with patients of different risk profiles. The demonstrations aim to show key characteristics of Shared Decision Making in a typical patient interaction.
This video shows a conversation with a Caucasian patient at average risk for prostate cancer.
This video shows a conversation with an African American patient at high risk.
When patients are deciding if the PSA test is right for them, there is no right or wrong answer. Patients should consider their individual risk, the benefits and possible harms, and what is right for them. Shared decision making can help you and the patient navigate this discussion. Decision aids and fact sheets can facilitate this conversation.
Continuing Medical Education
A Continuing Medical Education (CME) course, Prostate Cancer and Primary Care, is offered through the Massachusetts Medical Society. The course provides current research on prostate cancer, screening options, and the use of shared decision making around prostate cancer screening.
This information is provided by the Comprehensive Cancer Prevention and Control Network.