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The Research Question

Research assesses if a persuasive, evidence-based approach can help patients understand and accept controversial cancer screening recommendations. Findings indicate the importance of making harms clear before discussing benefits to influence patient behavior. Men were more accepting of recommendations against PSA screening, while women struggled to grasp mammography harms despite strong socialization. Providers play a crucial role in guiding patient decisions based on these recommendations.

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The Research Question

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  1. The Research Question Helping Patients Reach a Balanced Understanding of Controversial Cancer Screening Recommendations:The Impossible Dream? B Saver, R Luckmann, M Hayes, K Mazor, G Bacigalupe, J Calista, N Esparza, T Gorodetsky Why this is important? • The USPSTF has recently issued controversial recommendations about prostate cancer screening and mammography for women aged 40-49 • Patients and some providers are confused by the counterintuitive recommendations and conflicting evidence • Information alone rarely changes behavior – can a persuasive, evidence-based approach be effective?

  2. What the Researchers Did • Participants: 27 men aged 50-74 and 28 women aged 40-49 recruited from academic & community health center clinics • Design: For each topic, 2 English- and 1 Spanish-language focus group • Basic Method/Intervention: • Initial focus group on each topic presented information about tests, benefits, harms, guidelines and how generated • Scripts for subsequent focus groups modified to focus more on persuading participants to trust/believe USPSTF recommendations • Polled periodically during final groups for opinions about screening

  3. What the Researchers Found • Neither men nor women aware of USPSTF • No traction from distinguishing between processes used by USPSTF and other groups • No traction without first making harms clear • Men did not easily grasp cascade following abnormal PSA test, but readily understood and wished to avoid treatment harms • Women had much greater difficulty appreciating mammography harms • Socialization to the value of mammography is very strong, but providers are generally trusted

  4. What This Means for Clinical Practice • A persuasive approach, starting with making harms clear and then clarifying current knowledge about benefits, may help many men accept USPSTF recommendation against PSA screening • This approach for women and mammography may be less accepted • Provider recommendations are very important • USPSTF recommendations likely to change patient behavior only as they affect provider recommendations

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