Systematic Evaluation of Written Health Information on PSA Based Screening in Germany

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2019 Aug 9

PMID 31393928

Citations 2

Authors

Simone Beck

Birgit Borutta

Ulla Walter

Maren Dreier

Affiliations

Soon will be listed here.

Abstract

Background: Prostate-specific antigen (PSA) based screening for early detection of prostate cancer is common although it is associated with both benefits and potential harms (e.g., the risk of overdiagnosis). Evidence-based health information could help individuals make informed decisions about whether to undergo PSA testing or not. This evaluation aimed to determine whether the written health information materials available in Germany provide appropriate information for informed decision-making on PSA based screening.

Methods: A list of criteria was developed and used to systematically assess the quality of information on the benefits and harms of prostate cancer screening included in written health information materials. Fourteen information materials identified by information requests and online searches were evaluated independently by two of three reviewers. Consensus was achieved with a third reviewer.

Results: Of the 14 information materials evaluated, 10 (71%) list the ability to reduce the absolute risk of death from prostate cancer as a benefit of PSA testing, 9 (64%) point out the risks of follow-up diagnostics, 13 (93%) describe the risks of the available prostate cancer treatments, and all 14 specify the risk of overdiagnosis. The minority provide numerical data on benefits and risks. Partially mismatched framing was identified in four cases: two information materials report only the relative frequencies of benefits, and two report only the absolute frequencies of harms. Half of the materials encouraged participation using downplaying or frightening language.

Conclusions: The majority of health information materials in Germany describe the benefits and harms of PSA based screening, including overdiagnosis, but often lack adequate balance, neutrality and numbers.

Citing Articles

Including Information on Overdiagnosis in Shared Decision Making: A Review of Prostate Cancer Screening Decision Aids.

Pathirana T, Pickles K, Riikonen J, Tikkinen K, Bell K, Glasziou P MDM Policy Pract. 2022; 7(2):23814683221129875.

PMID: 36247841 PMC: 9558890. DOI: 10.1177/23814683221129875.

Harms and Benefits of Cancer Screening.

Robra B Recent Results Cancer Res. 2021; 218:85-104.

PMID: 34019164 DOI: 10.1007/978-3-030-63749-1_7.

References

CHARNOCK D, Shepperd S, Needham G, Gann R . DISCERN: an instrument for judging the quality of written consumer health information on treatment choices. J Epidemiol Community Health. 1999; 53(2):105-11. PMC: 1756830. DOI: 10.1136/jech.53.2.105. View

Draisma G, Boer R, Otto S, van der Cruijsen I, Damhuis R, Schroder F . Lead times and overdetection due to prostate-specific antigen screening: estimates from the European Randomized Study of Screening for Prostate Cancer. J Natl Cancer Inst. 2003; 95(12):868-78. DOI: 10.1093/jnci/95.12.868. View

Greenland S, ORourke K . On the bias produced by quality scores in meta-analysis, and a hierarchical view of proposed solutions. Biostatistics. 2003; 2(4):463-71. DOI: 10.1093/biostatistics/2.4.463. View

Sheridan S, Felix K, Pignone M, Lewis C . Information needs of men regarding prostate cancer screening and the effect of a brief decision aid. Patient Educ Couns. 2004; 54(3):345-51. DOI: 10.1016/j.pec.2003.12.003. View

Steckelberg A, Berger B, Kopke S, Heesen C, Muhlhauser I . [Criteria for evidence-based patient information]. Z Arztl Fortbild Qualitatssich. 2005; 99(6):343-51. View

Watson E, Hewitson P, Brett J, Bukach C, Evans R, Edwards A . Informed decision making and prostate specific antigen (PSA) testing for prostate cancer: a randomised controlled trial exploring the impact of a brief patient decision aid on men's knowledge, attitudes and intention to be tested. Patient Educ Couns. 2006; 63(3):367-79. DOI: 10.1016/j.pec.2006.05.005. View

Frosch D, Bhatnagar V, Tally S, Hamori C, Kaplan R . Internet patient decision support: a randomized controlled trial comparing alternative approaches for men considering prostate cancer screening. Arch Intern Med. 2008; 168(4):363-9. DOI: 10.1001/archinternmed.2007.111. View

Ecke T, Gunia S, Bartel P, Hallmann S, Koch S, Ruttloff J . Complications and risk factors of transrectal ultrasound guided needle biopsies of the prostate evaluated by questionnaire. Urol Oncol. 2008; 26(5):474-8. DOI: 10.1016/j.urolonc.2007.12.003. View

Elwyn G, OConnor A, Bennett C, Newcombe R, Politi M, Durand M . Assessing the quality of decision support technologies using the International Patient Decision Aid Standards instrument (IPDASi). PLoS One. 2009; 4(3):e4705. PMC: 2649534. DOI: 10.1371/journal.pone.0004705. View

10.

Jorgensen K, Brodersen J, Hartling O, Nielsen M, Gotzsche P . Informed choice requires information about both benefits and harms. J Med Ethics. 2009; 35(4):268-9. DOI: 10.1136/jme.2008.027961. View

11.

Gigerenzer G, Mata J, Frank R . Public knowledge of benefits of breast and prostate cancer screening in Europe. J Natl Cancer Inst. 2009; 101(17):1216-20. PMC: 2736294. DOI: 10.1093/jnci/djp237. View

12.

Bunge M, Muhlhauser I, Steckelberg A . What constitutes evidence-based patient information? Overview of discussed criteria. Patient Educ Couns. 2009; 78(3):316-28. DOI: 10.1016/j.pec.2009.10.029. View

13.

van Vugt H, Roobol M, Venderbos L, Joosten-van Zwanenburg E, Essink-Bot M, Steyerberg E . Informed decision making on PSA testing for the detection of prostate cancer: an evaluation of a leaflet with risk indicator. Eur J Cancer. 2009; 46(3):669-77. DOI: 10.1016/j.ejca.2009.11.022. View

14.

Costanza M, Luckmann R, Rosal M, White M, LaPelle N, Partin M . Helping men make an informed decision about prostate cancer screening: a pilot study of telephone counseling. Patient Educ Couns. 2010; 82(2):193-200. PMC: 2970646. DOI: 10.1016/j.pec.2010.05.011. View

15.

Korfage I, van den Bergh R, Essink-Bot M . Deciding on PSA-screening - Quality of current consumer information on the Internet. Eur J Cancer. 2010; 46(17):3073-81. DOI: 10.1016/j.ejca.2010.09.011. View

16.

Chan E, McFall S, Byrd T, Mullen P, Volk R, Ureda J . A community-based intervention to promote informed decision making for prostate cancer screening among Hispanic American men changed knowledge and role preferences: a cluster RCT. Patient Educ Couns. 2011; 84(2):e44-51. DOI: 10.1016/j.pec.2010.07.033. View

17.

Strobelberger M, Kaminski A, Gartlehner G . [Austrian patient information materials on PSA-screening do not meet international evidence-based standards]. Wien Med Wochenschr. 2011; 161(3-4):89-98. DOI: 10.1007/s10354-010-0855-5. View

18.

Chou R, Croswell J, Dana T, Bougatsos C, Blazina I, Fu R . Screening for prostate cancer: a review of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2011; 155(11):762-71. DOI: 10.7326/0003-4819-155-11-201112060-00375. View

19.

Wu G, Auvinen A, Maattanen L, Tammela T, Stenman U, Hakama M . Number of screens for overdetection as an indicator of absolute risk of overdiagnosis in prostate cancer screening. Int J Cancer. 2011; 131(6):1367-75. DOI: 10.1002/ijc.27340. View

20.

Lumen N, Fonteyne V, De Meerleert G, Ost P, Villeirs G, Mottrie A . Population screening for prostate cancer: an overview of available studies and meta-analysis. Int J Urol. 2011; 19(2):100-8. DOI: 10.1111/j.1442-2042.2011.02912.x. View