Prostate cancer pamphlets may encourage screening

Providing easy-to-read educational handouts to men can encourage discussion about prostate cancer and increase screening for elevated levels of prostate-specific antigen (PSA), a standard test used to detect an increased risk of prostate cancer, new research suggests. But, the use of these educational materials does not make men more inclined to undergo rectal examination, which can also detect cancer.

Physicians are advised to discuss prostate cancer with their patients so that they can make informed decisions about screening, note Dr. Sunil Kripalani, from Emory University School of Medicine in Atlanta, and colleagues. However, “few studies have tested strategies to encourage such discussions.”

As they report in the American Journal of Preventive Medicine, the researchers assessed the impact of providing low-literacy educational materials on prostate cancer discussion and screening in 250 men attending an inner-city primary care clinic.

The men were randomly assigned to receive one of three handouts: one had information on prostate cancer screening; one encouraged patients to talk with their physician about prostate cancer; and the third handout, having nothing to do with prostate cancer was used for comparison purposes.

Approximately 90 percent of the subjects were African American and nearly 80 percent read below the ninth grade level, the authors note.

Overall, 48.4 percent of the men said that they had discussed prostate cancer during their appointment. Analysis showed that such discussions were more common in the intervention groups than in the comparison group.

Furthermore, if prostate cancer was discussed, patients in the intervention groups were more likely to initiate the conversation than those in the comparison group.

Both intervention groups showed a marked increase in PSA testing relative to the comparison group, but not in screening by rectal examination.

“This study showed that two low-literacy interventions, including a patient education handout and a cue to talk to the doctor about prostate cancer, approximately double the odds of discussing prostate cancer in primary care visits,” the researchers conclude.

SOURCE: American Journal of Preventive Medicine, August 2007.

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