Influence of life expectancy on shared decision-making for prostate cancer screening.
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| Titel: | Influence of life expectancy on shared decision-making for prostate cancer screening. |
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| Autoren: | Reed MM; MD Program, Weill Cornell Medical College, New York, NY, USA., Mao J; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.; Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, 425 E 61st St, DV-306, New York, NY, USA., Davuluri M; Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, 425 E 61st St, DV-306, New York, NY, USA.; Department of Urology, Weill Cornell Medicine/NewYork-Presbyterian, New York, NY, USA., Patel NA; Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, 425 E 61st St, DV-306, New York, NY, USA.; Department of Urology, Weill Cornell Medicine/NewYork-Presbyterian, New York, NY, USA., Al Hussein Al Awamlh B; Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, 425 E 61st St, DV-306, New York, NY, USA.; Department of Urology, Weill Cornell Medicine/NewYork-Presbyterian, New York, NY, USA., Kensler KH; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA. kek4007@med.cornell.edu.; Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, 425 E 61st St, DV-306, New York, NY, USA. kek4007@med.cornell.edu. |
| Quelle: | Cancer causes & control : CCC [Cancer Causes Control] 2025 Dec; Vol. 36 (12), pp. 1891-1900. Date of Electronic Publication: 2025 Sep 10. |
| Publikationsart: | Journal Article |
| Sprache: | English |
| Info zur Zeitschrift: | Publisher: Kluwer Academic Publishers Country of Publication: Netherlands NLM ID: 9100846 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-7225 (Electronic) Linking ISSN: 09575243 NLM ISO Abbreviation: Cancer Causes Control Subsets: MEDLINE |
| Imprint Name(s): | Publication: Dordrecht : Kluwer Academic Publishers Original Publication: Oxford, UK : Rapid Communications of Oxford Ltd., 1990- |
| MeSH-Schlagworte: | Prostatic Neoplasms*/diagnosis , Prostatic Neoplasms*/epidemiology , Life Expectancy* , Decision Making, Shared* , Early Detection of Cancer*/methods , Early Detection of Cancer*/psychology , Early Detection of Cancer*/statistics & numerical data, Humans ; Male ; Aged ; Middle Aged ; Decision Making ; Prostate-Specific Antigen/blood ; Aged, 80 and over ; Behavioral Risk Factor Surveillance System |
| Abstract: | Competing Interests: Declarations. Conflict of interest: The authors declare no conflicts of interest with respect to this work. Ethical approval: This study was performed in accordance with the Declaration of Helsinki and deemed exempt by the institutional review board of Weill Cornell Medicine (Protocol 23-10036590). Consent to participate: BRFSS respondents provided oral consent to complete the survey. Purpose: The U.S. Preventive Services Task Force recommends that men aged 55-69 years undergo shared decision-making (SDM) regarding prostate cancer (PCa) screening, and routine screening is not recommended for older men or those with limited life expectancy. We evaluated the association between individual life expectancy and the receipt and content of SDM. Methods: We identified male respondents aged ≥ 50 years and older without a history of PCa within the 2020 Behavioral Risk Factor Surveillance System survey. SDM was defined as whether a healthcare professional had ever discussed the advantages and/or disadvantages of a prostate-specific antigen test with the respondent. Life expectancy was estimated based on a validated index incorporating respondent age, comorbidities, and activities of daily living. Adjusted odds ratios (aOR) were estimated for the associations between respondent age, life expectancy, and receipt of SDM, accounting for healthcare access and utilization-related factors. Results: Reported receipt of any SDM was highest among 70-74-year-old men (62.6%, 95% CI 60.5-64.6%). In multivariable models, those with the lowest life expectancy were modestly less likely to receive SDM (aOR = 0.84, 95% CI 0.71-0.99, Q4 vs Q1) compared to those with the greatest life expectancy. SDM discussing only the advantages of screening was the most common form of SDM; the content of SDM conversations did not differ by age or life expectancy, and 14.5% of men who were recently screened reported no prior SDM whatsoever. Conclusions: Life expectancy appears to be inadequately incorporated into decision-making regarding PCa screening. Additional tools are needed to support SDM conversations to improve the population benefits-harms of PCa screening. (© 2025. The Author(s).) |
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| Grant Information: | R00 CA245900 United States CA NCI NIH HHS; R00CA245900 United States CA NCI NIH HHS; R00CA245900 United States CA NCI NIH HHS |
| Contributed Indexing: | Keywords: Cancer screening; Life expectancy; Prostate cancer; Prostate-specific antigen; Shared decision-making |
| Substance Nomenclature: | EC 3.4.21.77 (Prostate-Specific Antigen) |
| Entry Date(s): | Date Created: 20250910 Date Completed: 20251119 Latest Revision: 20251122 |
| Update Code: | 20251122 |
| PubMed Central ID: | PMC12621089 |
| DOI: | 10.1007/s10552-025-02069-1 |
| PMID: | 40928602 |
| Datenbank: | MEDLINE |
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Nájsť tento článok vo Web of Science | Abstract: | Competing Interests: Declarations. Conflict of interest: The authors declare no conflicts of interest with respect to this work. Ethical approval: This study was performed in accordance with the Declaration of Helsinki and deemed exempt by the institutional review board of Weill Cornell Medicine (Protocol 23-10036590). Consent to participate: BRFSS respondents provided oral consent to complete the survey.<br />Purpose: The U.S. Preventive Services Task Force recommends that men aged 55-69 years undergo shared decision-making (SDM) regarding prostate cancer (PCa) screening, and routine screening is not recommended for older men or those with limited life expectancy. We evaluated the association between individual life expectancy and the receipt and content of SDM.<br />Methods: We identified male respondents aged ≥ 50 years and older without a history of PCa within the 2020 Behavioral Risk Factor Surveillance System survey. SDM was defined as whether a healthcare professional had ever discussed the advantages and/or disadvantages of a prostate-specific antigen test with the respondent. Life expectancy was estimated based on a validated index incorporating respondent age, comorbidities, and activities of daily living. Adjusted odds ratios (aOR) were estimated for the associations between respondent age, life expectancy, and receipt of SDM, accounting for healthcare access and utilization-related factors.<br />Results: Reported receipt of any SDM was highest among 70-74-year-old men (62.6%, 95% CI 60.5-64.6%). In multivariable models, those with the lowest life expectancy were modestly less likely to receive SDM (aOR = 0.84, 95% CI 0.71-0.99, Q4 vs Q1) compared to those with the greatest life expectancy. SDM discussing only the advantages of screening was the most common form of SDM; the content of SDM conversations did not differ by age or life expectancy, and 14.5% of men who were recently screened reported no prior SDM whatsoever.<br />Conclusions: Life expectancy appears to be inadequately incorporated into decision-making regarding PCa screening. Additional tools are needed to support SDM conversations to improve the population benefits-harms of PCa screening.<br /> (© 2025. The Author(s).) |
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| ISSN: | 1573-7225 |
| DOI: | 10.1007/s10552-025-02069-1 |