We want to thank Urology and the Editorial Response authors for 1 considering the importance of how the social
determinants of health (SDH) affect shared decision making (SDM) for prostate cancer
screening. Health literacy (HL) plays a particularly important role in prostate cancer
screening, when considering the best interest of the patient and mitigating over-utilization
of health care resources. It is well documented that racial barriers influence access
to health care screening; surprisingly, our study illustrates that African-American
men had higher rates of PSA testing. This was an interesting finding given African-American
men are more likely to report lower levels of health literacy. This discrepancy may
be due to the practice of SDM. With ambiguous guideline recommendations on PSA testing,
prostate cancer screening remains a more complicated space, requiring the fine balance
of patient beneficence, non-maleficence, justice and autonomy. When counseling patients
and considering their preferences it is important to consider how HL, race and other
SDH factor into the SDM process. Moving forward we recommend continued investment
in community programs which promote HL, in addition to population-based study of how
SDH influence the SDM model of prostate cancer screening.
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Article info
Publication history
Accepted:
May 2,
2021
Received:
January 22,
2021
Identification
Copyright
© 2021 Published by Elsevier Inc.
