Informed Decision Making:
How to Make a Personal Health Care Choice

The Public Health Problem

In 2005,* 185,895 new cases of prostate cancer were diagnosed and 28,905 men died of the disease, according to United States Cancer Statistics. Currently, there is no scientific consensus on effective strategies to reduce the risk of prostate cancer. Additionally, there is no agreement on the effectiveness of screening or that the potential benefits outweigh the risks. Therefore, public health agencies face significant challenges in determining what actions to take to address prostate cancer.

Given the uncertainty about the benefit of screening, the principal public health approach is to support informed decision making about screening. Public health agencies and related organizations are attempting to provide men with current information about the benefits and risks of prostate cancer screening so that each man can make his own decision, given his own values and preferences.

Informed decision making occurs when a man—

• Understands the nature and risks of prostate cancer.
• Understands the risks, benefits, and alternatives to prostate cancer screening.
• Participates in decision making at a level he desires.
• Makes a decision consistent with his preferences and values, or defers the decision to a later time.

Shared decision making is a process carried out between a patient and his health care professional in a clinical setting where both parties share information, and the man makes an informed decision about prostate cancer screening.

U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2005 Incidence and Mortality Web-based Report. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2009. Available at: http://www.cdc.gov/uscs.

*The most recent year for which statistics are currently available.

CDC’s Response

CDC and other federal agencies follow the prostate cancer screening guidelines set forth by the U.S. Preventive Services Task Force (USPSTF), led by the Agency for Healthcare Research and Quality.

CDC has developed a portfolio of educational materials designed to promote discussion between patients and physicians and to help men aged 50 to 74 years make informed decisions about prostate cancer screening. These materials include—

Prostate Cancer Screening: A Decision Guide (PDF-118KB) is an easy-to-read booklet, organized in question and answer format, designed to help a man decide whether screening is right for him. The guide discusses the prostate, prostate cancer, and the available screening tests.

Prostate Cancer Screening: A Decision Guide for African Americans (PDF-155KB) targets African-American men. At all ages, African-American men die of prostate cancer more often than other men do. The reasons for the variation among groups are unknown, making it critical that African-American men know the facts about prostate cancer and the available screening tests.

La Detección del Cáncer de Próstata: Una Guía para Hispanos en los Estados Unidos (PDF-512KB) is 24-page booklet, written in Spanish, provides basic information and encourages Hispanic men to decide whether screening is the right choice for them.