Decision aids for prostate cancer in diverse minority men

This post describes a study, Decision aids for localized prostate cancer in diverse minority men: Primary outcome results from a multicenter cancer care delivery trial (Alliance A191402CD), about the relative effects of decision aids (DAs) for prostate cancer, delivered within the clinical encounter and in more diverse patient populations. The study was published in December 2021 in the journal Cancer.

Prostate cancer remains the most common noncutaneous malignancy in men. Complicating matters further, African American males are more likely to develop prostate cancer than males from other racial groups. They are also more likely to develop aggressive forms of prostate cancer and die from the disease. Decision aids (DAs)—tools to promote shared decision-making—have been shown to improve patient knowledge, potentially reduce decisional conflict in prostate cancer treatment decisions, and thereby facilitate shared decision-making.

A multicenter cluster randomized controlled trial, conducted in urology practices in a community oncology research base, sought to test whether previsit and within-visit DAs would each independently improve patient knowledge in a diverse population that intentionally oversampled minority men with localized prostate cancer facing an initial treatment decision.

The study found that neither the DA delivered before the visit nor the DA delivered within the visit significantly improved patient-reported knowledge.

However, despite these results, the study sheds light on the importance of shared decision-making for localized prostate cancer in several ways:

• It helps describe the effectiveness of DAs in minority men with localized prostate cancer.
• It begins to address the optimal timing of DA delivery in the clinical setting.
• The study also shows that it is feasible to enroll large proportions of minority patients in practice-based cancer care delivery trials.
• Testing DAs delivered at different times and incorporating a large number of underrepresented Black or African American men, who are at higher risk for worse oncologic and functional outcomes than other racial groups, creates a valuable baseline for similar comparisons of DA modes for future studies.