Decisions around prostate-specific antigen screening require a patient-centred approach, considering the benefits and risks of potential harm. Using shared decision-making (SDM) can improve men’s knowledge and reduce decisional conflict. SDM is supported by evidence, but can be difficult to implement in clinical settings. An inclusive definition of SDM was used in order to determine the prevalence of SDM in prostate cancer screening decisions. Despite consensus among guidelines endorsing SDM practice, the prevalence of SDM occurring before the decision to undergo or forgo prostate-specific antigen testing varied between 11% and 98%, and was higher in studies in which SDM was self-reported by physicians than in patient-reported recollections and observed practices. The influence of trust and continuity in physician–patient relationships were identified as facilitators of SDM, whereas common barriers included limited appointment times and poor health literacy. Decision aids, which can help physicians to convey health information within a limited time frame and give patients increased autonomy over decisions, are underused and were not shown to clearly influence whether SDM occurs. Future studies should focus on methods to facilitate the use of SDM in clinical settings.

关于前列腺特异性抗原筛查的决策需要采取以患者为中心的方法，同时考虑潜在危害的益处和风险。使用共享决策（SDM）可以提高男性的知识并减少决策冲突。SDM 有证据支持，但在临床环境中可能难以实施。使用 SDM 的包容性定义是为了确定 SDM 在前列腺癌筛查决策中的患病率。尽管支持 SDM 实践的指南已达成共识，但在决定接受或放弃前列腺特异性抗原检测之前发生的 SDM 患病率在 11% 至 98% 之间变化，并且在由医生自我报告的 SDM 的研究中发生率高于患者- 报告回忆和观察到的做法。医患关系中信任和连续性的影响被认为是 SDM 的促进因素，而常见的障碍包括有限的预约时间和较差的健康素养。决策辅助工具可以帮助医生在有限的时间内传达健康信息，并赋予患者更大的决策自主权，但其未得到充分利用，并且没有显示出对 SDM 是否发生有明显影响。未来的研究应侧重于促进 SDM 在临床环境中使用的方法。