Men considering a hypothetical treatment for prostate cancer: A comparison to patients Lori Van Manen a,d, * , Deb Feldman-Stewart b,c,d , Michael D. Brundage b,d,e a Kingston General Hospital, 76 Stuart Street, Kingston, ON, Canada K7L 2V7 b Division of Cancer Care and Epidemiology, Queen’s Cancer Research Institute, Queen’s University, Kingston, ON, Canada c Department of Psychology, Queen’s University, Kingston, ON, Canada d Department of Oncology, Queen’s University, Kingston, ON, Canada e Community Health and Epidemiology, Queen’s University, Kingston, ON, Canada Received 4 December 2003; received in revised form 2 February 2005; accepted 12 February 2005 Abstract Background: In facilitating informed decision making about PSA screening, men are often asked to consider the potential consequences of the test, including a diagnosis of prostate cancer and how they would want to be treated. However, there is no empirical evidence thus far demonstrating that men are able to consider this hypothetical situation in a realistic manner. Purpose: To compare the features (attributes) of treatments that are important to non-patient men considering a hypothetical diagnosis of prostate cancer with those deemed important to men actually diagnosed with early-stage disease. Methods: Two groups of men went through a decision aid interview to help them choose between treatment options for early-stage prostate cancer: non-patient men who imagined themselves to be diagnosed with the disease, and newly diagnosed patients. During the interview participants identified features of the treatment and disease that were important to their decisions. Results: The percentage of non-patients and patients that thought particular attributes were important was correlated: r (33) = 0.77, p < 0.01. The effects on bladder and bowel functioning were considered important to 50% of each group. In addition to the 22 attributes initially presented, 49% of non-patients and 67% of patients identified additional attributes as being important to their decision. Eight (42%) of the 19 additional attributes were identified by non-patients and patients alike. Conclusions: The group of non-patient men provided a close approximation to the group of newly diagnosed men with respect to the attributes identified as being important to their treatment decisions for early-stage prostate cancer, suggesting that the consideration of what is important to the decision by non-patient men is realistic. # 2005 Elsevier Ireland Ltd. All rights reserved. Keywords: Decision aids; Decision making; PSA screening; Prostate cancer 1. Introduction Screening decisions pose particular challenges to people facing decisions about their medical care. In facilitating informed decision making, the individual may be asked to consider: the purpose of the screening; the potential for false positive or negative findings; the uncertainties and risks attached to the screening process; and any significant medical, social or financial implications of screening for the particular condition [1]. The medical implications of a screening test may be particularly complicated, and to ensure that an informed decision is made, one might also be asked to consider all of the possible outcomes of the screening test, and how they could be handled [2]. However, whether or not an individual can imagine these situations in a realistic manner is questionable. Testing for the presence of prostate specific antigen (PSA) is one screening test, and its use in Ontario has increased by 388% between 1996 and 2000 [3]. The efficacy of PSA screening in picking up early-stage prostate cancer, www.elsevier.com/locate/pateducou Patient Education and Counseling 61 (2006) 33–42 * Corresponding author. Tel.: +1 613 544 2631x2801; fax: +1 613 545 5722. E-mail address: lori.vanmanen@krcc.on.ca (L. Van Manen). 0738-3991/$ – see front matter # 2005 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.pec.2005.02.002