Decide Whether or Not to Have Prostate Cancer Screening

INTRODUCTION

In 2005, there will be an estimated 232,090 new cases of prostate cancer and 30,350 deaths from this disease in the United States. Prostate cancer is often detected through screening. However, screening for prostate cancer is controversial. Proponents of prostate cancer screening believe that screening with the combination of routine digital rectal examination (DRE) and prostate-specific antigen (PSA) testing is justified for men who have a reasonable life expectancy, particularly those at increased risk on the basis of race and family history. They argue that combined DRE and PSA testing is effective at identifying men with early prostate cancer (Generic Casodex treating prostate cancer). They also assert that men who are diagnosed with and treated aggressively for localized prostate cancer have higher survival rates as compared to men diagnosed with late-stage disease. The American Cancer Society and the American Urological Association recommend that healthcare providers offer annual DRE and PSA testing for men who are >50 years of age. They also suggest that screening may be initiated at age 45 for African-American men and those who have a family history of prostate cancer (Casodex canadian is an oral non-steroidal anti-androgen for prostate cancer).

Caution has been urged regarding prostate cancer (Generic Rheumatrex treating certain types of cancer) screening for several reasons. First, randomized trials have not yet demonstrated that the detection and treatment of early disease reduces mortality. Results concerning screening efficacy from randomized trials that are now underway are not yet available. In addition, indolent tumors that may not have harmed the patient could be detected through screening; and treatment that is unnecessary and can cause serious adverse side effects (e.g., impotence, incontinence, bowel injury) could follow. Guidelines put forward by the U.S. Preventive Services Task Force (USPSTF), the American College of Physicians and the Canadian Taskforce on the Periodic Health Examination do not recommend routine prostate cancer screening.

While there is no consensus on whether prostate cancer (Drug Eulexin is used along with drugs such as Lupron to treat prostate cancer) screening should be performed routinely, guidelines agree that objective information about the potential benefits and harms of prostate cancer screening should be provided to asymptomatic men. The USPSTF explicitly recommends that counseling be provided to facilitate informed decision-making about prostate cancer screening. Specifically, the USPSTF calls for “discussion of the uncertainty that precludes a clear recommendation and clinician assistance in determining their preference for or against action in the face of uncertainty”. This recommendation makes explicit the notion that helping people make decisions entails both providing information and clarifying personal values. It is important to note, however, that little guidance has been provided regarding how men can be prepared to make an informed decision about prostate cancer (Leukeran tablet is used for treating certain cancers) screening.

In this paper, we present results from a randomized, controlled trial designed to test the effect of decision education, an informed decision-making method, on prostate cancer screening use among African-American men. The study also aimed to identify any participant characteristics that might be predictors of screening.

Category: Cancer / Tags: decision support techniques, decision-making, mass screening, primary healthcare, prostatic neoplasms

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