Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
Eur J Cancer. 2010 Nov;46(17):3073-81. doi: 10.1016/j.ejca.2010.09.011.
Given that screening for prostate cancer has the potential to reduce prostate cancer mortality at the expense of considerable overdiagnosis and overtreatment, the availability of core consumer information - correct, balanced and supportive of autonomous decision-making - is a must. We assessed the quality of consumer information available through the Internet per November 2009 and its possible contribution to informed decision-making by potential screenees.
Consumer information on PSA-screening was sought through the Internet in November 2009. Materials had to be targeted at potential consumers, offered by not-for-profit organisations, released in 2005 or after, in English or Dutch. Per material 2 of the authors assessed independently from each other whether standardised pre-defined topics were addressed, whether the content was correct and which approach was taken towards the decision-making process about uptake.
Twenty-three materials were included, of which 11 were released (shortly) after the results of 2 large randomized-controlled trials (RCTs) that evaluated the effectiveness of screening for prostate cancer had been published in March 2009. That a PSA-test result can be abnormal because of non-cancerous conditions (false positive) and that it may miss prostate cancer (false negative) was not addressed in 2/23 and 8/23 materials, respectively. The risk of overdiagnosis and overtreatment was not mentioned in 6 out of 23. PSA-screening was presented as a usual thing to do in some materials, whereas other materials emphasised the voluntary nature of PSA-screening ('it is your decision'). The content of 19/23 materials was considered sufficiently informative according to the pre-defined criteria, 12/23 materials were considered supportive of informed decision-making by men.
Most materials of not-for-profit organizations supplied adequate information about PSA-screening, whilst the degree of persuasion towards uptake reflected variations in opinions on men's autonomy regarding their own health.
鉴于前列腺癌筛查有可能降低前列腺癌死亡率，但也存在大量过度诊断和过度治疗的风险，因此必须提供核心的消费者信息——正确、平衡且支持自主决策。我们评估了截至 2009 年 11 月通过互联网提供的消费者前列腺癌筛查信息的质量，以及其对潜在筛查对象做出知情决策的可能贡献。
我们于 2009 年 11 月通过互联网搜索前列腺特异性抗原（PSA）筛查的消费者信息。这些材料必须针对潜在消费者，由非营利组织提供，于 2005 年或之后发布，语言为英语或荷兰语。每篇材料由两位作者独立评估，标准预先确定的主题是否得到解决，内容是否正确，以及对决策过程中接受度的方法。
共纳入 23 篇材料，其中 11 篇是在 2009 年 3 月发表了两项大型随机对照试验（RCT）结果之后（不久）发布的，这两项 RCT 评估了前列腺癌筛查的效果。有 2/23 和 8/23 的材料没有提到 PSA 检测结果可能因非癌性疾病（假阳性）而异常，也可能漏诊前列腺癌（假阴性）。6/23 的材料未提及过度诊断和过度治疗的风险。有些材料将 PSA 筛查描述为常规做法，而其他材料则强调 PSA 筛查的自愿性质（“这是你的决定”）。根据预先确定的标准，23 篇材料中有 19 篇被认为内容充分，12 篇材料被认为对男性做出知情决策有帮助。
大多数非营利组织的材料提供了足够的 PSA 筛查信息，而对接受度的说服力反映了对男性自主权的不同意见，即他们对自己健康的自主权。
