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