September is Prostate Cancer Awareness Month and there is no better time to remind physicians and care teams that shared decision making in the clinical setting is an effective strategy to help facilitate prostate cancer screening improvement.
- By 2030, decrease the prostate cancer mortality rate to less than or equal to 17 per 100,000 for all Ohio men in each racial/ethnic group
- By 2030, increase the percent of males 40 years of age and older who have had a discussion with their health care provider on the advantages and disadvantages of the prostate-specific antigen (PSA) test from 15.8% to 25.3%.
Although cancer affects all populations groups, black men bear a disproportionate amount of prostate cancer burden compared with their white male counterparts. Black men are approximately 60% more likely to be diagnosed and more than twice as likely to die from prostate cancer as white men. Despite this statistic, PSA rates among Black men are significantly lower than white men.
The American Urological Association (AUA) recognizes that men at higher risk for prostate cancer, such as Black men, may realize added benefit from earlier screening. In a retrospective, cross-sectional analysis of 2010 and 2015 National Health Review Survey data, Black men with recent PSA test were 1.48 times more likely to have engaged in full-shared decision making than white men.
Prostate cancer decision aids and educational interventions may help facilitate shared decision making among your male patients. The AUA recommends:
- Considerations for screening based on risk-to-benefit ratios
- The likelihood of false positive and false-negative results
- Description of options after abnormal PSA is detected
- Considerations for biopsies and treatment options based on patient clinical presentations.
For additional educational support, the American Academy of Family Physicians offers resources on how to counsel your patients on prostate cancer screening and six simple steps to shared decision making.