Impact of numeracy on understanding of prostate cancer risk reduction in PSA screening

Kevin Koo, Charles D Brackett, Ellen H Eisenberg, Kelly A Kieffer and Elias S Hyams

PLOS ONE, 2017, vol. 12, issue 12, 1-11

Abstract: Prostate-specific antigen (PSA) screening for prostate cancer in men of average risk remains controversial. Patients’ ability to incorporate risk reduction data into their decision-making may depend on their numeracy. We assessed the impact of patients’ numeracy on their understanding of the risk reduction benefits of PSA screening. Men attending a general internal medicine clinic were invited to complete a survey. Four versions of the survey each included a three-item numeracy test and PSA risk reduction data, framed one of four ways: absolute (ARR) versus relative risk reduction (RRR), with or without baseline risk (BR). Respondents were asked to adjust their perceived risk of prostate-cancer mortality using the data presented. Accuracy of risk reduction was evaluated relative to how risk data were framed. Among a total of 200 respondents, a majority incorrectly answered one or more of the numeracy items. Overall accuracy of risk adjustment was only 20%. Accuracy varied with data framing: when presented with RRR, respondents were 13% accurate without BR and 31% accurate with BR; when presented with ARR, they were 0% accurate without BR and 35% accurate with BR. Including BR data significantly improved accuracy for both RRR (P = 0.03) and ARR groups (P

Date: 2017
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0190357

DOI: 10.1371/journal.pone.0190357

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