基于 PSA 检测前列腺癌的知情决策：风险指标传单评估。

Informed decision making on PSA testing for the detection of prostate cancer: an evaluation of a leaflet with risk indicator.

机构信息

Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands.

出版信息

Eur J Cancer. 2010 Feb;46(3):669-77. doi: 10.1016/j.ejca.2009.11.022.

DOI:10.1016/j.ejca.2009.11.022

PMID:20022239

Abstract

BACKGROUND

Population-based screening for prostate cancer (PCa) remains controversial. To help men making informed decisions about prostate specific antigen (PSA) screening a risk indicator (www.uroweb.org) was developed. This risk indicator is embedded in a leaflet that informs men about the pros and cons of PCa screening and enables calculation of the individual risk of having a biopsy detectable PCa.

AIM

To assess the effect of providing a leaflet including individualized risk estimation on informed decision making of men, i.e. knowledge about PCa and PSA screening, attitude towards undergoing a PSA test and intention to have a PSA test.

METHODS

An intervention study among 2000 men, aged 55-65 years, randomly selected from the population registry of the city of Dordrecht, the Netherlands, in 2008. Men were sent a questionnaire on knowledge of PCa, attitude and intention to have a PSA test. Men without a history of (screening for) PCa were sent the leaflet and Questionnaire 2 within 2 weeks after returning Questionnaire 1. Validated health and anxiety measures were used.

RESULTS

One thousand and twenty seven of 2000 men completed Questionnaire 1 (51%), of whom 298 were excluded due to a history of (screening for) PCa. Of the 729 remaining men, 601 completed Questionnaire 2 as well. At the second assessment significantly more men met the requirements of informed decision making (15% versus 33%, p<0.001), more men had relevant knowledge (284/601, 50% versus 420/601, 77%, p<0.001) and the intention to have a PSA test had increased (p<0.001).

CONCLUSIONS

Providing information on PCa screening combined with individualized risk estimation enhanced informed decision making and may be used for shared decision making on PSA screening of physicians and patients.

摘要

背景

前列腺癌（PCa）的人群筛查仍然存在争议。为了帮助男性做出有关前列腺特异性抗原（PSA）筛查的明智决策，开发了一个风险指标（www.uroweb.org）。该风险指标嵌入在一份传单中，告知男性 PCa 筛查的利弊，并能够计算出进行活检可检测到 PCa 的个体风险。

目的

评估提供包含个体风险估计的传单对男性知情决策的影响，即对 PCa 和 PSA 筛查的了解、对进行 PSA 测试的态度以及进行 PSA 测试的意愿。

方法

这是一项 2008 年在荷兰多德雷赫特市的人口登记处随机选择的 2000 名 55-65 岁男性的干预研究。男性收到了一份关于 PCa 知识、对进行 PSA 测试的态度和意愿的问卷。没有 PCa 病史（筛查）的男性在返回问卷 1 后两周内收到了传单和问卷 2。使用了经过验证的健康和焦虑测量方法。

结果

2000 名男性中有 1027 名完成了问卷 1（51%），其中 298 名由于有（筛查）PCa 病史而被排除在外。在剩下的 729 名男性中，有 601 名完成了问卷 2。在第二次评估中，更多的男性符合知情决策的要求（15%对 33%，p<0.001），更多的男性具有相关知识（284/601，50%对 420/601，77%，p<0.001），并且进行 PSA 测试的意愿增加（p<0.001）。