Prostate disorders diagnosis and management review with an osteopathic component

2022 ◽  
pp. 23-28
Author(s):  
Elizabeth V. George ◽  
Helaine Larsen
Keyword(s):  
Prostate Cancer ◽  
Primary Care ◽  
Decision Making ◽  
Care Setting ◽  
Primary Care Setting ◽  
Prostate Cancer Screening ◽  
Management Approach ◽  
Shared Decision ◽  
Laboratory Examination ◽  
Prostate Disease

Physicians commonly encounter disorders of the prostate in the primary care setting, where shared decision making for prostate cancer screening should also occur. Hence, it is important for physicians to understand and differentiate the diagnoses of prostate disease. Initial evaluation should include a thorough history, physical examination, laboratory examination and imaging, if necessary. This article aims to provide a diagnostic and management approach for prostate disease.

Approaches to shared decision-making for PSA screening in primary care practice.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 33-33
Author(s):  
Cara B Litvin ◽  
Steven M. Ornstein ◽  
Lynne Nemeth
Keyword(s):  
Prostate Cancer ◽  
Primary Care ◽  
Decision Making ◽  
Patient Education ◽  
Shared Decision Making ◽  
Prostate Cancer Screening ◽  
Shared Decision ◽  
Psa Screening ◽  
Care Practices ◽  
Primary Care Practices

33 Background: In April 2017, the United States Preventive Services Task Force published a draft statement recommending that clinicians inform men ages 55 to 65 about the potential benefits and harms of prostate-specific antigen (PSA)-based screening for prostate cancer. The HIT-OVERUSE study is an ongoing 2 year group randomized study in 20 primary care practices to test a practice-based intervention to reduce overuse, including avoidance of routine PSA screening without shared decision making. The purpose of this report is to present qualitative findings about approaches participating practices have adopted to facilitate shared decision-making for PSA screening. Methods: Eleven practices in ten states randomized to the HIT-OVERUSE intervention group have hosted on-site visits for academic detailing and participatory planning and sent two practice representatives to a one day meeting to share ‘best practices.’ Detailed notes from site visits, follow-up emails, and the ‘best practice’ meeting were reviewed to identify strategies adopted by practices to facilitate shared decision-making for PSA screening for prostate cancer screening. Results: All practices adopted at least one strategy to promote shared-decision making for PSA screening. Four practices removed standing orders for routine PSA screening. Four practices educated their clinical staff about the test; three developed scripts for staff to use when asked by patients about the test. Six practices began using patient education handouts about PSA screening. One provider started showing a brief YouTube video with patients, while another practice developed a slide show to show in the waiting room. Most providers in nearly all practices reported modifying their conversation about PSA screening with patients to include some discussion about the benefits and the harms of screening. Conclusions: Primary care practices participating an intervention to reduce overuse have adopted varied approaches to facilitate shared-decision making for prostate cancer screening. While having face-to-face conversations is one approach, other strategies may employ staff or utilize patient education or videos to convey the benefits and harms of screening.

Shared decision-making and informed choice for the early detection of prostate cancer in primary care

2005 ◽  
Vol 96 (9) ◽  
pp. 1209-1210 ◽  
Author(s):  
Suzanne K. Steginga ◽  
Carole Pinnock ◽  
Claire Jackson ◽  
Tony Gianduzzo
Keyword(s):  
Prostate Cancer ◽  
Primary Care ◽  
Decision Making ◽  
Early Detection ◽  
Shared Decision Making ◽  
Informed Choice ◽  
Shared Decision

Patient preference for prostate-specific antigen testing: A population-based analysis.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 188-188
Author(s):  
S. L. Chang ◽  
J. C. Presti ◽  
J. P. Richie
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
Cancer Screening ◽  
Patient Preferences ◽  
Prostate Cancer Screening ◽  
Population Based ◽  
Decision Making Process ◽  
Shared Decision ◽  
Psa Testing ◽  
History Of

188 Background: The AUA and American Cancer Society both recommend a shared decision-making process between clinicians and patients for prostate cancer screening with PSA testing. Data are limited data regarding patient preferences for PSA evaluation in the United States. We assessed the sociodemographic and clinical characteristics of men who proceeded with or opted out of PSA testing in a nationally representative population-based cohort. Methods: We analyzed male participants from the 2001 to 2008 cycles of the National Health and Nutrition Examination Survey (NHANES) who were 40 years old or older without a history of prostate cancer, recent prostate manipulation, or hormone therapy use (n = 6,032). All men underwent or refused PSA testing after a standardized explanation about prostate cancer screening by a physician. A multivariate logistic regression was conducted after adjusting for survey weights to identify independent sociodemographic and clinical predictors for opting out of PSA testing. Results: Overall, 5% of the study cohort refused PSA testing. The analysis revealed predictors for refusing PSA testing (Table). PSA testing preference was not influenced by a family history of prostate cancer, previous prostate cancer screening, education level, socioeconomic status, insurance status, or tobacco history. There were no significant time trends for PSA testing. Conclusions: Despite equal access to PSA testing in our study, there was unequal utilization. We found that Black men were more likely to refuse PSA testing. Our analysis also suggests that a perception of suboptimal health or uncertain future outlook may discourage men from undergoing PSA evaluation. These patient preferences for PSA evaluation should be factored into the shared decision-making process for prostate cancer screening. [Table: see text] No significant financial relationships to disclose.

Prostate cancer screening patterns among LGBT populations.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19077-e19077
Author(s):  
Sung Jun Ma ◽  
Oluwadamilola Temilade Oladeru ◽  
Joseph Miccio ◽  
Katy Wang ◽  
Kristopher Attwood ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
Shared Decision Making ◽  
Prostate Cancer Screening ◽  
Specific Antigen ◽  
Weighted Estimate ◽  
Shared Decision ◽  
Psa Screening ◽  
Lgbt Populations ◽  
Do So

e19077 Background: More than 10 million Americans identify themselves as lesbian, gay, bisexual, and transgender (LGBT), and the majority of male-to-female (MTF) transgender individuals still have prostates even after surgical transitions. Guidelines on prostate specific antigen (PSA) screening for LGBT populations are limited, and informed and shared decision making are encouraged by various organizations. However, patterns of care for PSA screening in LGBT populations remains unclear. To address this knowledge gap, we conducted a cross sectional study to evaluate self-reported PSA screening and decision making among LGBT populations. Methods: The Behavioral Risk Factor Surveillance System database was queried for LGBT adults from 2014-2016 and 2018. Those with prior prostate cancer were excluded. Multivariable logistic regression was performed to evaluate the association of LGBT status with PSA screening, informed and shared decision making, after adjusting for demographic characteristics and survey weights. Results: A total of 164,370 participants were eligible for PSA screening (n = 156,548 for cisgender [CG]+straight, n = 156 for MTF+straight, n = 33 for MTF+gay, n = 52 for MTF+bisexual, n = 51 for MTF+other sexual orientation [SO], n = 3354 for CG+gay, n = 1641 for CG+bisexual, n = 2535 for CG+other SO), representing a weighted estimate of 1.2 million LGBT populations. When compared to CG+straight, CG+gay/bisexual cohorts were more likely to undergo PSA screening within the past 2 years (CG+gay: OR 1.08, p < 0.001; CG+bisexual: OR 1.06, p < 0.001), have ever received PSA screening (CG+gay: OR 1.30, p < 0.001; CG+bisexual: OR 1.12, p < 0.001), and be recommended for PSA screening by their physicians (CG+gay and bisexual: OR 1.16, p < 0.001). All other cohorts were less likely to do so (all OR < 1, p < 0.05). MTF+gay and CG+gay participants were more likely to make informed decision (MTF+gay: OR 3.13, p < 0.001; CG+gay: OR 1.09, p < 0.001), while all other cohorts were less likely to do so (all OR < 1, p < 0.05). CG+gay participants were also more likely to share decision (OR 2.51, p < 0.001), while there were no associations for all other cohorts (all p > 0.05). Conclusions: Select gay populations were more likely to undertake PSA screening recommended by their physicians and participate in informed and shared decision making. However, other LGBT populations were less likely to make informed decisions, and transgender participants were less likely to undergo PSA screening. Further research efforts are needed to improve informed and shared decision making for PSA screening in such underserved population.

Prostate cancer screening and shared decision-making preferences among African-American members of the Prince Hall Masons

2008 ◽  
Vol 17 (10) ◽  
pp. 1006-1013 ◽  
Author(s):  
Randi M. Williams ◽  
Nicole L. Zincke ◽  
Ralph O. Turner ◽  
Jackson L. Davis ◽  
Kimberly M. Davis ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
African American ◽  
Cancer Screening ◽  
Shared Decision Making ◽  
Prostate Cancer Screening ◽  
Shared Decision

Measuring Informed Decision Making about Prostate Cancer Screening in Primary Care

2011 ◽  
Vol 32 (2) ◽  
pp. 327-336 ◽  
Author(s):  
Amy Leader ◽  
Constantine Daskalakis ◽  
Clarence H. Braddock ◽  
Elisabeth J. S. Kunkel ◽  
James R. Cocroft ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Primary Care ◽  
Decision Making ◽  
Cancer Screening ◽  
Prostate Cancer Screening ◽  
Informed Decision ◽  
Informed Decision Making
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