Classifying the reasons men consider to be important in prostate-specific antigen (psa) testing decisions: Evaluating risks, lay beliefs, and informed decisions

Background: Despite uncertainty regarding the benefits of prostate cancer screening, many men have had a prostate-specific antigen (PSA) test. Purpose: This study aims to identify classes of reasons guiding men's decisions about prostate cancer screening and predict reasoning approaches by family history and prior screening behaviour. Methods: First-degree relatives of men with prostate cancer (n = 207) and men from the general population (n = 239) of Australia listed reasons they considered when deciding whether to have a PSA test. Results: Responses were coded into 31 distinct categories. Latent class analysis identified three classes. The evaluation of risk information cues class (20.9 %) contained a greater number of men with a family history (compared with control and overcome cancer/risk class; 52.7 %). Informed decisions and health system class (26.5 %) included a lower proportion of men who had had a PSA test and greater proportions of highly educated and married men. Conclusion: Understanding the reasons underlying men's screening decisions may lead to a more effective information provision and decision support.