Knowledge and practices regarding prostate cancer screening in Spanish men: The importance of personal and clinical characteristics (PROSHADE study)

Lucy A. Parker; Juan-Pablo Caballero-Romeu; Elisa Chilet-Rosell; Ildefonso Hernandez-Aguado; Luis Gómez-Pérez; Pablo Alonso-Coello; Ana Cebrián; Maite López-Garrigós; Irene Moral-Pélaez; Elena Ronda; Mercedes Gilabert; Carlos Canelo-Aybar; Ignacio Párraga-Martínez; Mª del Campo-Giménez; Blanca Lumbreras

doi:10.1371/journal.pone.0303203

Peer Review History

Original SubmissionFebruary 29, 2024
22 Mar 2024 Decision Letter - Ismaheel Lawal, Editor PONE-D-24-07506Knowledge and practices regarding prostate cancer screening in Spanish men: the importance of personal and clinical characteristics (PROSHADE study)PLOS ONE Dear Dr. Lumbreras, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by May 06 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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If your ethics statement is written in any section besides the Methods, please move it to the Methods section and delete it from any other section. Please ensure that your ethics statement is included in your manuscript, as the ethics statement entered into the online submission form will not be published alongside your manuscript. 4. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. 5. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 3. 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Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: In the modern era of prostate cancer detection, the most important thing is how regularly men are exposed to PSA testing, and since most prostate cancers are detected at a localized or locally advanced stage without symptoms, the systems in place to make PSA testing universal, and the availability of this information on a regular basis, are very different in different countries. Therefore, globally, the results of a cross-sectional study from Spain, a developed country in Western Europe, that gives us an indication of the universal situation in 2022, are very relevant. As the authors note, the 2012 USPSFT guideline against widespread PSA testing has served to replicate US standards in other countries, without taking into account the different circumstances in each country. Minor point 1. of the 95.4% who said they knew about prostate cancer, the level of knowledge can vary widely. I would like to see more discussion of the very different 61.9% of people who said they knew about the PSA, and the contrast between awareness of PCa and awareness of the PSA in the abstract, as it would be rather odd not to have heard of prostate cancer itself through various media if a binary question was attempted. I think this difference in awareness of these two questions is the most important point to emphasize in the paper, as it is the only preparation for prostate cancer that the public can actually do. 2. Awareness of PSA is very low, especially in Asia. In South Korea, which is considered a developed country, only 9.7% of men over the age of 40 recognized the value of PSA as a screening test in a random survey of men over the age of 40. Please cite additional country-specific data on the social awareness of PSA testing in general in Europe, Africa, as well as Asia. Jong Hyun Pyun, Seok Ho Kang, Ji Youn Kim, Jae Eun Shin, In Gab Jeong, Jong Wook Kim, Tae Il No, Jong Jin Oh, Ji Hyung Yu, Ho Seok Chung, Seong Soo Jeon Survey Results on the Perception of Prostate-Specific Antigen and Prostate Cancer Screening Among the General Public Korean J Urol Oncol. 2020;18(1):40-46. Published online April 29, 2020 ( https://doi.org/10.22465/kjuo.2020.18.1.40 ) Reviewer #2: This is a well-written and methodologically sound paper meriting publication. It deals with the controversial field of prostate cancer screening and knowledge determinants for PSA screening to ultimately inform their screening decision aid for Spanish men For the introduction, line 104-105, I suggest making this statement specific -there is limited data published on knowledge of PSA and of screening tests in general and the recent published data is mainly coming for disadvantaged and high-risk populations - see latest references the authors seem to have missed -doi: 10.1155/2019/2463048 , 10.4314/ejhs.v33i3.19 , https://doi.org/10.1177/1557988316689497 For results section line 302-303 -do the authors mean with respect to sociodemographic characteristics? Line 496 I suggest replacing primary studies with primary education Line 581 -surely it should be similarities with other Spanish populations? ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Young Hwii Ko Reviewer #2: Yes: Dr Maureen Joffe ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0303203.r001
Revision 1
18 Apr 2024 Author Response Thank you for your thoughtful comments on our manuscript “Knowledge and practices regarding prostate cancer screening in Spanish men: the importance of personal and clinical characteristics (PROSHADE study)”. Below, we answer the reviewer’s questions. The revised version is attached. Neither the manuscript that we submit to you nor any similar paper, in whole or in part, has been or will be submitted to or published in any other scientific journal. All authors accept the uniform requirements for biomedical journals, as well as those required by PLos One. All authors have read and approved the paper and will be happy to enclose signatures if required. Research was funded by the Instituto de Salud Carlos III, code PI20/01334, co-financed with FEDER funds from the European Union “A way of doing Europe”. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We thank you for your consideration and look forward to hearing from you. Blanca Lumbreras Department of Public Health, History of Science and Gynecology, Miguel Hernández University , and CIBER en Epidemiología y Salud Pública, Spain. Crtra Alicante-Valencia km 81. Sant Joan d’Alacant, 03550, Alicante, Spain Phone number: +34965919510 Email: blumbreras@umh.es Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf Done 2. Thank you for stating the following financial disclosure: " Instituto de Salud Carlos III, code PI20/01334" Please state what role the funders took in the study. If the funders had no role, please state: ""The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."" If this statement is not correct you must amend it as needed. Please include this amended Role of Funder statement in your cover letter; we will change the online submission form on your behalf. We have included this statement in the cover letter and in the manuscript. 3. Your ethics statement should only appear in the Methods section of your manuscript. If your ethics statement is written in any section besides the Methods, please move it to the Methods section and delete it from any other section. Please ensure that your ethics statement is included in your manuscript, as the ethics statement entered into the online submission form will not be published alongside your manuscript. We have moved the ethic statement to the method section. 4. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. We have included captions of the Supporting Information files at the end of the manuscript (S1 table STROBE Statement—Checklist of items that should be included in reports of cross-sectional studies). 5. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Done Reviewers' comments: Reviewer #1: In the modern era of prostate cancer detection, the most important thing is how regularly men are exposed to PSA testing, and since most prostate cancers are detected at a localized or locally advanced stage without symptoms, the systems in place to make PSA testing universal, and the availability of this information on a regular basis, are very different in different countries. Therefore, globally, the results of a cross-sectional study from Spain, a developed country in Western Europe, that gives us an indication of the universal situation in 2022, are very relevant. As the authors note, the 2012 USPSFT guideline against widespread PSA testing has served to replicate US standards in other countries, without taking into account the different circumstances in each country. Minor point 1. of the 95.4% who said they knew about prostate cancer, the level of knowledge can vary widely. I would like to see more discussion of the very different 61.9% of people who said they knew about the PSA, and the contrast between awareness of PCa and awareness of the PSA in the abstract, as it would be rather odd not to have heard of prostate cancer itself through various media if a binary question was attempted. I think this difference in awareness of these two questions is the most important point to emphasize in the paper, as it is the only preparation for prostate cancer that the public can actually do. The reviewer is right, most of the interviewed men had knowledge about PCa (95.4%). Of the 1,067 surveyed men, only 573 (50.3%) reported that they had knowledge about the PSA test (67.7% of the respondents, we made a mistake in the initial data). As the reviewer pointed out, this is very relevant since the lack of awareness related to the PSA test is a barrier to the shared decision making in PCa screening. We have included this sentence in the abstract section (page 3, lines 64-65 and lines 71-72). 2. Awareness of PSA is very low, especially in Asia. In South Korea, which is considered a developed country, only 9.7% of men over the age of 40 recognized the value of PSA as a screening test in a random survey of men over the age of 40. Please cite additional country-specific data on the social awareness of PSA testing in general in Europe, Africa, as well as Asia. Jong Hyun Pyun, Seok Ho Kang, Ji Youn Kim, Jae Eun Shin, In Gab Jeong, Jong Wook Kim, Tae Il No, Jong Jin Oh, Ji Hyung Yu, Ho Seok Chung, Seong Soo Jeon Survey Results on the Perception of Prostate-Specific Antigen and Prostate Cancer Screening Among the General Public Korean J Urol Oncol. 2020;18(1):40-46. Published online April 29, 2020 ( https://doi.org/10.22465/kjuo.2020.18.1.40 ) We have included a more detailed description about the difference awareness of PSA test and PCa in different regions around the world (discussion, pages 27-28, lines 560-579). Reviewer #2: This is a well-written and methodologically sound paper meriting publication. It deals with the controversial field of prostate cancer screening and knowledge determinants for PSA screening to ultimately inform their screening decision aid for Spanish men For the introduction, line 104-105, I suggest making this statement specific -there is limited data published on knowledge of PSA and of screening tests in general and the recent published data is mainly coming for disadvantaged and high-risk populations - see latest references the authors seem to have missed -doi: 10.1155/2019/2463048 , 10.4314/ejhs.v33i3.19 ,https://doi.org/10.1177/1557988316689497 Following the reviewer’s suggestion, we have highlighted this point and we have introduced these relevant references (introduction, page 6, lines 132-134). For results section line 302-303 -do the authors mean with respect to sociodemographic characteristics? Yes, we referred to sociodemographic characteristics. We have added this concept to clarify the sentence (results, page 15, line 347). Line 496 I suggest replacing primary studies with primary education Done (discussion, page 26, line 543) Line 581 -surely it should be similarities with other Spanish populations? Yes, we have added this term (discussion, page 29, line 654). https://doi.org/10.1371/journal.pone.0303203.r002
22 Apr 2024 Decision Letter - Ismaheel Lawal, Editor Knowledge and practices regarding prostate cancer screening in Spanish men: the importance of personal and clinical characteristics (PROSHADE study) PONE-D-24-07506R1 Dear Dr. Lumbreras, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Ismaheel Lawal, MD, Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0303203.r003
Formally Accepted
8 May 2024 Acceptance Letter - Ismaheel Lawal, Editor PONE-D-24-07506R1 PLOS ONE Dear Dr. Lumbreras, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks to review your paper and let you know the next and final steps. Lastly, if your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. If we can help with anything else, please email us at customercare@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Ismaheel Lawal Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0303203.r004

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