Candidate for the Lee B. Lusted Student Prize Competition
Purpose: To understand how men integrate information about prostate cancer risks and screening guidelines to make judgements about prostate cancer and exploring whether having a first-degree family history influences how this information is integrated.
Method: First-degree relatives of men with prostate cancer (n=32) and men without a family history of prostate cancer (n=50) from Queensland, Australia completed a policy-capturing study. Forty-eight distinct profiles were created based on a full factorial design utilising four cues: family history (none, brother, father, brother and father), age (40’s, 50’s, 60’s), physician discussion (yes, no), and symptoms (presence, absence). Participants rated each profile according to their perception of the stimulus’s prostate cancer risk and whether the stimulus should consider prostate cancer screening.
Result: Multi-level modelling analyses were employed to predict the use of information cues on perceived risk ratings and on prostate cancer screening recommendations and to explore family history status as a moderator of these ratings. Family history, older age, and the presence of urinary symptoms in stimulus profiles were associated with greater judgements of prostate cancer risk by all men. First-degree relatives of men with prostate cancer weighted the family history cue lower in their judgements of risk than did men without a family history. There was minimal variability in the endorsement of prostate cancer screening across profiles and most men recommended screening for all stimulus men regardless of the values of information cues.
Conclusion: Family history is an important information cue for all men in determining judgements of prostate cancer risk. However, first-degree relatives weight the family history cue lower than do men without a family history when making judgements about prostate cancer risk where they consider the specific nature of the family history. First-degree relatives of men with prostate cancer consider the broader context of having a relative with prostate cancer and incorporate this information in determining their judgements which may have implications on the informed decision-making process.