“Selling” the positive message about individual testing

A paper in the July issue of Psychological Science addresses the influence of men’s perceptions on their willingness to be tested for prostate cancer (at least in one part of Germany).

Sieverding and her colleagues have actually been studying this issue for a while. In an earlier report they had showed that when they talked with men > 45 years of age in two German cities about getting tested for risk of prostate and colon cancers, men who had never been tested tended to believe that most other men also hadn’t ever been tested either.

In their newly published report, Sieverding et al. have now shown that what and how men are told about the “local” degree of participation in prostate cancer testing also profoundly influences the behavior of men who have not undergone testing for prostate cancer. (Is this a form of peer pressure?)

Sieverding et al. exposed men who had never been tested for prostate cancer risk to one or other of two written health information statements:

  • Either that 18 percent of German men had been tested for prostate cancer in the past 12 months (which was completely true)
  • Or that 65 percent of German men had been tested for prostate cancer (which was also completely true — over their lifetime)

After reading either the first or the second of these two statements, men were asked to indicate whether they personally planned to undergo standard testing for prostate cancer risk in the upcoming year.

The results of this study showed that:

  • Men who were shown the 65 percent statistic were much more likely to indicate that they would have prostate cancer testing in the next 12 months than men who were told the 18 percent statistic.
  • Men who were shown the 18 percent statistic were less likely to provide their name and address to receive further information about prostate cancer testing by mail, thus indicating that the information they were given may actually have had a demotivating effect.

Sieverding and her colleagues conclude that “a simple shift in public health messaging could potentially have a big impact on the motivational power of any health promotion campaign, whether the subject be prostate cancer screening or another important health concern, such as good hygiene or vaccinations.”

Quoted in a news release from the Association for Psychological Science, Dr. Sieverding said what this study really shows is that, despite all of the challenges inherent in getting people to think about screening tests for cancer risk, it is clear that the way you frame the conversation about whether they personally intend to get tested can profoundly impact the likelihood of a positive (or negative) response.

There has been an historic tendency in the prostate cancer community to send messages stating that “not enough men go and get regular tests for their risk of prostate cancer.” If the research presented by Sieverding and her colleagues is correct, and our goal is to get more men to have regular testing for risk for prostate cancer, then it is clear that the message we need to be able to send is more like, “70 percent of American men of 50 years or older have had a PSA test to assess their risk for prostate cancer.” Of course this begs the question of whether we have accurate data on what percentages of American men > 40, > 50, and >60 years of age have, in fact, ever had a PSA test. There were some data presented at the ASCO annual meeting in 2008 suggesting that African Americans and white Americans were actually both getting tested over time at rates in the high 60 percent range.

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