Introduction: Men with a BRCA2 mutation are at an increased risk of developing adverse consequences from prostate cancer, including metastatic disease and death. Unlike women with a BRCA mutation who are counselled on the option of prophylactic surgery to prevent advanced malignancies, men with BRCA mutations lack an evidence-based resource to guide shared decision-making regarding management options for their prostate cancer screening and prevention. The objective of this study was to develop a patient decision aid (PtDA) using an evidence-based process to facilitate shared decision-making for men with a BRCA2 mutation considering prophylactic prostatectomy.

Methods: The International Patient Decision Aids Standards and the Ottawa Decision Support Framework were used to guide the development process. A steering committee of urologists, geneticists, genetics counsellors, patient advocates, research associates, and PtDA specialists was assembled. An online survey was used to obtain input from members of the steering committee regarding data to include on the PtDA. A literature review was performed to identify the outcomes of each management strategy. A PtDA was then created based on the best available literature available.   

Results: A novel, evidence-based PtDA was created to facilitate shared decision-making for men with a BRCA2 mutation considering prophylactic prostatectomy. The management options included were: 1) prophylactic prostatectomy or 2) monitoring with blood work and imaging tests. A summary of evidence tables was created to organize the data available for each outcome from the literature review. The current PtDA contains 14 pages and is at a SMOG ninth-grade reading level. 

Conclusions: We have created a novel PtDA to facilitate shared decision-making for men with a BRCA2 mutation considering a prophylactic prostatectomy. The next step in this project involves testing the tool for its acceptability among patients and other healthcare providers.