Treatment decisions for localized prostate cancer: a concept mapping approach

<jats:title>Abstract</jats:title><jats:sec><jats:title>Objective</jats:title><jats:p>Few decision aids emphasize active surveillance (<jats:styled-content style="fixed-case">AS</jats:styled-content>) for localized prostate cancer. Concept mapping was used to produce a conceptual framework incorporating <jats:styled-content style="fixed-case">AS</jats:styled-content> and treatment.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Fifty‐four statements about what men need to make a decision for localized prostate cancer were derived from focus groups with <jats:styled-content style="fixed-case">A</jats:styled-content>frican <jats:styled-content style="fixed-case">A</jats:styled-content>merican, <jats:styled-content style="fixed-case">L</jats:styled-content>atino and white men previously screened for prostate cancer and partners (<jats:italic>n</jats:italic> = 80). In the second phase, 89 participants sorted and rated the importance of statements.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>An eight cluster map was produced for the overall sample. Clusters were labelled <jats:italic>Doctor–patient exchange, Big picture comparisons, Weighing the options, Seeking and using information, Spirituality and inner strength, Related to active treatment, Side‐effects</jats:italic> and <jats:italic>Family concerns</jats:italic>. A major division was between medical and home‐based clusters. Ethnic groups and genders had similar sorting, but some variation in importance. <jats:styled-content style="fixed-case">L</jats:styled-content>atinos rated <jats:italic>Big picture comparisons</jats:italic> as less important. African Americans saw <jats:italic>Spirituality and inner strength</jats:italic> most important, followed by Latinos, then whites. Ethnic‐ and gender‐specific concept maps were not analysed because of high similarity in their sorting patterns.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>We identified a conceptual framework for management of early‐stage prostate cancer that included coverage of <jats:styled-content style="fixed-case">AS</jats:styled-content>. Eliciting the conceptual framework is an important step in constructing decision aids which will address gaps related to <jats:styled-content style="fixed-case">AS</jats:styled-content>.</jats:p></jats:sec>