PSA screening: low-income group lagging behind

  • Prostate Cancer Prostatic Dis

  • aus Deepa Koli
  • Studien - kurz & knapp
Der Zugang zum gesamten Inhalt dieser Seite ist nur Angehörigen medizinischer Fachkreise vorbehalten. Der Zugang zum gesamten Inhalt dieser Seite ist nur Angehörigen medizinischer Fachkreise vorbehalten.

Takeaway

  • Screening rates increased with age, household income, and insurance status.
  • Lower odds of PSA screening among blacks disappeared after adjusting for socioeconomic status.

Why this matters

  • Variation in PSA testing recommendations for early detection of prostate cancer has put primary care physicians in a dilemma.
  • PSA screenings have declined since the US Preventive Services Task Force 2012 recommendation, which dichotomized the screening decision to a yes/no outcome.
  • This decline may adversely affect black men who are at high risk.
  • The importance of physician-patient communication on PSA screening "cannot be overstated," according to the authors.

Study design

  • 22,167 black, 9588 white men (aged 40-79 y) were assessed 2002-2009.
  • Funding: NIH.

Key results

  • Black men had lower annual household income and rate of insurance vs white men (P<.001).
  • In both groups, odds of screening rose with increasing age and household income (Plinear trend<.001 for all).
  • Whites vs blacks were more likely, overall, to receive PSA screening (OR, 1.15; 95% CI, 1.08-1.22).
  • In men aged ≥50 y, PSA testing was significantly higher in whites vs blacks.
  • However, after adjusting for socioeconomic and insurance status, overall PSA screening was significantly lower among white men (OR, 0.81; 95% CI, 0.76-0.87).

Limitations

  • Questionnaire-based study.