Men with high health literacy are more likely than others to get PSA testing, however when the advantages and disadvantages are discussed with a doctor this reduces slightly, a new US study suggests.

The opposite is true for men with low health literacy, who are more likely to undergo PSA screening when optimal shared decision-making is present compared with no discussion, the researchers report in the journal Cancer.

“These findings highlight the dynamic interplay between both providers and their patients as well as between the latter’s HL (high literacy) and SDM (shared decision-making) that should inform the creation and promulgation of SDM guidelines, specifically when considering patients with low HL,” the researchers write.

“For example, ensuring that SDM is appropriately catered to the patient’s HL level is essential,” add the team led by David-Dan Nguyen of Brigham and Women’s Hospital in Massachusetts.