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Shared medical decision in prostate cancer screening in primary care: a systematic literature review of current evidence

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Abstract

Purpose

Prostate cancer screening has not significantly reduced mortality. International guidelines strongly endorse shared decision-making to navigate risks, emphasizing its crucial role prior to prescribing a prostate-specific antigen test. This study aims to provide insight into the current role of shared decision-making in primary care for prostate cancer screening and suggest ways to improve the process.

Methods

PubMed, Cochrane, and Lissa databases were searched for following terms: ‘prostate-specific antigen’ or ‘prostate cancer screening’ combined with ‘shared decision making’, ‘informed decision making’ or ‘decision support’ and ‘primary care’. All studies were screened by two independent reviewers. This systematic review followed the PRISMA guidelines.

Results

Of 85 articles screened, 34 were included. Key findings included heterogenous and poor quality implementation of shared decision-making in practice, patients with limited knowledge of shared decision-making, clinicians infrequently discussing patients’ views, decision aids that could be better integrated into practice, and finally, changes in care systems to support the expansion of shared decision-making in prostate cancer screening.

Conclusion

Decision aids are essential tools in the informed decision-making process. Integrating these elements into practice would require training for doctors and adjustments to the healthcare system.

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Acknowledgements

The authors would like to express their gratitude to the department of general practice of Aix-Marseille University for his support.

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Authors and Affiliations

  1. Department of General Practice, Aix-Marseille University, 27 Bd Jean Moulin, 13385, Marseilles, France

    Romain Lutaud, Quentin Ollivier & Thomas Fierling

  2. Aix-Marseille University, CNRS, EFS, ADES, Marseilles, France

    Romain Lutaud

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  1. Romain Lutaud
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Contributions

Conceptualization, RL and TF ; Methodology, RL and TF ; Formal Analysis, RL and QO; Review Investigation, RL and QO; Writing—Original Draft Preparation, RL and QO and TF; Writing—Review and Editing, RL and QO; Visualization, RL and QO; Supervision, TF

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Correspondence to Romain Lutaud.

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Lutaud, R., Ollivier, Q. & Fierling, T. Shared medical decision in prostate cancer screening in primary care: a systematic literature review of current evidence. Int Urol Nephrol (2024). https://doi.org/10.1007/s11255-024-03947-4

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