Prostate Cancer Screening: Using Informed Decision Making in Primary Care Settings

Since 2012, multiple new guidelines have been issued advising changes in screening for prostate cancer (PC). New guidelines suggest limiting the frequency of prostate cancer screening, although prostate cancer is now the most prevalent form of cancer in males 30 years and older in the United States (National Comprehensive Cancer Network [NCCN], 2015). Guidelines from various associations continue to advocate for screening, while others call for reducing the use of tests such as the Prostate Specific Antigen (PSA) to screen for PC. Such variance in the recommendations has created confusion among primary care clinicians and male patients (Jacobson, 2013). While screening recommendations are not clear from one accrediting body to another, many recommend the use of Informed Decision-Making to assist in educating providers and patients about the prostate cancer screening process. As recent years have brought change to the prostate cancer screening process, groups such as the American Cancer Society (ACS) have encouraged each male patient to decide if screening is right for them. This project will focus on the implementation of an informed decision-making tool that will educate providers and encourage provider-patient discussion about prostate cancer screening. In order for this project to be successful, several objectives were implemented and evaluated. The objectives include: 1) Identify the barriers to provider-patient education and discussion regarding prostate cancer screening. 2) Assess current use of Informed Decision Making Tools and select two tools that are readily available and practical for healthcare providers to share with their patients to better facilitate provider-patient education and discussion regarding the most up-to-date prostate cancer screening practices. 3) Increase awareness and knowledge of prostate cancer screening practices through educational presentation and distribution of the available informed decision-making tool to primary care clinicians in the Southern Utah area. 4) Disseminate the project to the Snowbird Primary Care Conference 2017 to raise awareness of the use of informed decision-making tools. The four objectives were implemented and evaluated through steps that include: the synthesis of a literature review, the selection of two informed decision making tools, a pre-implementation survey, a provider education meeting, a post-implementation survey, and dissemination of the project results. After the implementation of this project, primary care clinicians reported a 62.5% greater awareness, knowledge and comfort level with the use of informed decision-making tools in their practice and a 100% increase in the use of educational handouts with their patients. In summary, Prostate Cancer screening guidelines recommend the use of an informed decision-making process with patients. This project focused upon educating providers of available informed decision-making tools and improved patient-provider discussion.