e23188 Background: Recent data suggest that prostate cancer mortality may be increasing for the first time in 20 years, possibly related to a decrease in PSA screening. Most professional societies recommend men aged 55 to 69 make screening decisions using a shared-decision making (SDM) model. However the quality and time of SDM can vary significantly, often leaving patients uncertain about the implications of pursuing or foregoing screening. In this setting of individualized decisions, patients may seek supplemental information. However, little is known about the accuracy, breadth and readability of available education materials, which if designed optimally could improve SDM. Methods: For 11 predetermined professional societies (ACP, ACPM, ACS, AFP, AMA, ASCO, AUA, CDC, NCI, NIH, USPSTF), patient education materials designed for prostate cancer screening were queried. Materials were analyzed using seven well-validated readability metrics and evaluated for educational content. For content comparison, 10 materials from academic cancer centers and independent organizations were identified using top public search engine results. Results: We identified 12 professional society materials and 20 from popular non-society sources. Mean readability level for society materials ranged from 9.7 to 11.3 grade, well above AMA and NIH recommended 6th and 8th grade reading levels (P < 0.0001). In comparison to general materials, professional society materials more often discussed the role of risk factors in making screening decisions (70% vs 100%, P = 0.03). However, society materials did often omit important guideline-based content, including statements that decisions should involve patient values and preferences (42%) and can vary by patient age (35%). Conclusions: Widely available prostate cancer screening education materials are written at inappropriately high reading levels and often omit important content. Improvement of such materials would encourage SDM for patients considering screening.[Table: see text]
Moral hazard and health insurance: examining the role of private vs. Public insurance in prostate cancer screening, prostate cancer diagonosis and patient satisfaction with prostate cancer care
