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WASHINGTON— Men plan to continue getting prostate-specific antigen (PSA) tests despite recommendations that suggests men should not be screened, according to a new study by researchers at RTI International.
In October 2011, the U.S. Preventive Services Task Force, an independent panel of experts in primary care and prevention, released a new recommendation advising men against getting a PSA test, which screens for prostate cancer. The task force concluded that many men are harmed as a result of prostate cancer screening and few, if any, benefit.
The study, published in the American Journal of Preventive Medicine, surveyed 1,089 men who did not have a history of prostate cancer and were 40 to 74 years old. The survey, conducted about one month after the task force released the new recommendation, measured men’s initial response to the recommendation. Men were shown the recommendation and asked to what extent they agreed or disagreed with it and when/if they planned to get a PSA test. Men were also asked whether or not they were confident that the recommendation was based on the latest research.
The researchers found that despite the fact that most participants (61 percent) agreed with the new PSA testing recommendation and were confident that the recommendation was based on the latest research (69 percent), only 13 percent intended to follow it and not get a PSA test. More than half of men (54 percent) surveyed still plan to get a PSA test in the future, and one-third of participants were undecided.
“Since cancer screening has been promoted as a way to save lives, this recommendation may seem counterintuitive to many people,” said Linda Squiers, Ph.D., senior health communication scientist at RTI and the paper's lead author.
Men who were in their 50s were significantly more likely than men in their 40s to disagree with the recommendation not to get screened. Black men, men with higher incomes, those who had had a PSA in the previous two years, and men who were somewhat or very worried about getting prostate cancer were also more likely to say they will not follow the new recommendation.
More than 70 percent of participants did not discuss the potential benefits or harm of screening with their healthcare provider. Those who did remember such a discussion only remember hearing of the benefits of testing.
"We need to do a better job of presenting both the benefits and harms of screening to all patients and explaining the science behind the recommendation in plain language so everyone can understand it," Squiers said.
In May 2013, the American Urological Association altered its position, recommending against routine screening among men age 40 to 54 years and age 70 and older, but it continues to advocate for informed decision-making for men age 55 to 69 years.
