Prostate-specific antigen testing rates in high-risk populations: results from the All of Us Research Program.
Cancer screening
Early detection of cancer
Health disparities
Prostate cancer
Prostate-specific antigen
Journal
Cancer causes & control : CCC
ISSN: 1573-7225
Titre abrégé: Cancer Causes Control
Pays: Netherlands
ID NLM: 9100846
Informations de publication
Date de publication:
25 Oct 2023
25 Oct 2023
Historique:
received:
11
07
2023
accepted:
20
09
2023
medline:
25
10
2023
pubmed:
25
10
2023
entrez:
25
10
2023
Statut:
aheadofprint
Résumé
Early detection of prostate cancer using prostate-specific antigen (PSA) remains controversial and disparities in the receipt of prostate cancer screening persist in the US. We sought to examine disparities in PSA testing rates among groups with higher prostate cancer risk and differential access to healthcare. We identified a cohort of 37,706 males within the All of Us Research Program without a history of prostate cancer between the ages of 40 and 85 at time of enrollment (2017-2021). Incidence rate ratios (IRR) for the number of PSA tests received during follow-up through December 2021 were estimated using age- and multivariable-adjusted negative binomial regression models. PSA testing frequencies in the cohort were compared with population-based estimates from the 2020 Behavioral Risk Factor Surveillance System (BRFSS). A total of 6,486 males (17.2%) received at least one PSA test over the course of follow-up. In multivariable-adjusted models, non-Hispanic Black males received PSA tests at a 17% lower rate (IRR = 0.83, 95% CI 0.76, 0.90) than non-Hispanic White males. Higher educational attainment, higher annual income, having self-/employer-purchased insurance, having a spouse or domestic partner, and having a family history of prostate cancer were all associated with higher rates of PSA testing. The proportion of males ages 55 to 69 who received a PSA test within two years was lower in All of Us (12.4%, 95% CI 11.8-13.0%) relative to population-based estimates from the BRFSS (35.2%, 95% CI 34.2-36.3%). Absolute PSA testing rates in All of Us were lower than population-based estimates, but associations with PSA testing in the cohort mirrored previously reported disparities in prostate cancer screening. These findings highlight the importance of addressing barriers to care in order to reduce disparities in cancer screening.
Sections du résumé
BACKGROUND
BACKGROUND
Early detection of prostate cancer using prostate-specific antigen (PSA) remains controversial and disparities in the receipt of prostate cancer screening persist in the US. We sought to examine disparities in PSA testing rates among groups with higher prostate cancer risk and differential access to healthcare.
METHODS
METHODS
We identified a cohort of 37,706 males within the All of Us Research Program without a history of prostate cancer between the ages of 40 and 85 at time of enrollment (2017-2021). Incidence rate ratios (IRR) for the number of PSA tests received during follow-up through December 2021 were estimated using age- and multivariable-adjusted negative binomial regression models. PSA testing frequencies in the cohort were compared with population-based estimates from the 2020 Behavioral Risk Factor Surveillance System (BRFSS).
RESULTS
RESULTS
A total of 6,486 males (17.2%) received at least one PSA test over the course of follow-up. In multivariable-adjusted models, non-Hispanic Black males received PSA tests at a 17% lower rate (IRR = 0.83, 95% CI 0.76, 0.90) than non-Hispanic White males. Higher educational attainment, higher annual income, having self-/employer-purchased insurance, having a spouse or domestic partner, and having a family history of prostate cancer were all associated with higher rates of PSA testing. The proportion of males ages 55 to 69 who received a PSA test within two years was lower in All of Us (12.4%, 95% CI 11.8-13.0%) relative to population-based estimates from the BRFSS (35.2%, 95% CI 34.2-36.3%).
CONCLUSION
CONCLUSIONS
Absolute PSA testing rates in All of Us were lower than population-based estimates, but associations with PSA testing in the cohort mirrored previously reported disparities in prostate cancer screening. These findings highlight the importance of addressing barriers to care in order to reduce disparities in cancer screening.
Identifiants
pubmed: 37878135
doi: 10.1007/s10552-023-01807-7
pii: 10.1007/s10552-023-01807-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NCI NIH HHS
ID : P20CA233255
Pays : United States
Organisme : NCI NIH HHS
ID : R00CA245900
Pays : United States
Informations de copyright
© 2023. The Author(s).
Références
Siegel RL, Miller KD, Fuchs HE, Jemal A (2022) Cancer statistics. CA 72:7–33
pubmed: 35020204
Kensler KH, Rebbeck TR (2020) Cancer progress and priorities: prostate cancer. Cancer Epidemiol Biomarkers Prev 29:267–277. https://doi.org/10.1158/1055-9965.EPI-19-0412
doi: 10.1158/1055-9965.EPI-19-0412
pubmed: 32024765
pmcid: 7006991
Pinsky PF, Parnes H (2023) Screening for prostate cancer. N Engl J Med 388:1405–1414. https://doi.org/10.1056/NEJMcp2209151
doi: 10.1056/NEJMcp2209151
pubmed: 37043655
Grossman DC et al (2018) Screening for prostate cancer: US preventive services task force recommendation statement. JAMA 319:1901–1913. https://doi.org/10.1001/jama.2018.3710
doi: 10.1001/jama.2018.3710
pubmed: 29801017
Kensler KH et al (2021) Racial and ethnic variation in PSA testing and prostate cancer incidence following the 2012 USPSTF recommendation. JNCI 113:719–726
doi: 10.1093/jnci/djaa171
pubmed: 33146392
Jemal A et al (2015) Prostate cancer incidence and PSA testing patterns in relation to USPSTF screening recommendations. JAMA 314:2054–2061. https://doi.org/10.1001/jama.2015.14905
doi: 10.1001/jama.2015.14905
pubmed: 26575061
Desai MM et al (2022) Trends in incidence of metastatic prostate cancer in the US. JAMA Netw Open 5:e222246–e222246. https://doi.org/10.1001/jamanetworkopen.2022.2246
doi: 10.1001/jamanetworkopen.2022.2246
pubmed: 35285916
pmcid: 9907338
Sheng IY et al (2021) Implications of the United States preventive services task force recommendations on prostate cancer stage migration. Clin Genitourin Cancer 19:e12–e16. https://doi.org/10.1016/j.clgc.2020.06.006
doi: 10.1016/j.clgc.2020.06.006
pubmed: 32800474
Sammon JD et al (2014) Contemporary nationwide patterns of self-reported prostate-specific antigen screening. JAMA Intern Med 174:1839–1841. https://doi.org/10.1001/jamainternmed.2014.4117
doi: 10.1001/jamainternmed.2014.4117
pubmed: 25179266
Vetterlein MW et al (2018) State-by-state variation in prostate-specific antigen screening trends following the 2011 United States preventive services task force panel update. Urology 112:56–65. https://doi.org/10.1016/j.urology.2017.08.055
doi: 10.1016/j.urology.2017.08.055
pubmed: 29056579
Kalavacherla S et al (2023) Low-value prostate-specific antigen screening in older males. JAMA Netw Open 6:e237504–e237504. https://doi.org/10.1001/jamanetworkopen.2023.7504
doi: 10.1001/jamanetworkopen.2023.7504
pubmed: 37040113
pmcid: 10091155
Salmon C, Parent M-É, Quesnel-Vallée A, Barnett TA (2022) A scoping review of social relationships and prostate cancer screening. Prev Med 154:106892. https://doi.org/10.1016/j.ypmed.2021.106892
doi: 10.1016/j.ypmed.2021.106892
pubmed: 34798197
Moses KA et al (2017) The impact of sociodemographic factors and PSA screening among low-income Black and White men: data from the Southern Community Cohort Study. Prostate Cancer Prostatic Dis 20:424–429. https://doi.org/10.1038/pcan.2017.32
doi: 10.1038/pcan.2017.32
pubmed: 28695916
pmcid: 5861729
Alkhatib, K. A.-O. et al. Does Veteran Status Mitigate Racial Disparities in Prostate Cancer Screening? Analysis of Prostate Specific Antigen Screening Patterns in the 2018 Behavioral Risk Factor Surveillance System Data.
Trinh QD et al (2016) Determinants of cancer screening in Asian-Americans. Cancer Causes Control 27:989–998. https://doi.org/10.1007/s10552-016-0776-8
doi: 10.1007/s10552-016-0776-8
pubmed: 27372292
Lillard JW Jr, Moses KA, Mahal BA, George DJ (2022) Racial disparities in Black men with prostate cancer: A literature review. Cancer 128:3787–3795. https://doi.org/10.1002/cncr.34433
doi: 10.1002/cncr.34433
pubmed: 36066378
Basourakos SP et al (2022) Harm-to-benefit of three decades of prostate cancer screening in black men. NEJM Evid. https://doi.org/10.1056/evidoa2200031
doi: 10.1056/evidoa2200031
pubmed: 35721307
pmcid: 9202998
Kensler KH et al (2023) Prostate cancer screening in African American men: a review of the evidence. J Natl Cancer Inst. https://doi.org/10.1093/jnci/djad193
doi: 10.1093/jnci/djad193
pubmed: 37713266
Denny JC (2019) The “All of Us” research program. N Engl J Med 381:668–676
doi: 10.1056/NEJMsr1809937
pubmed: 31412182
Behavioral Risk Factor Surveillance System, Centers for Disease Control and Prevention (U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, Georgia, 2020).
Croswell JM, Ransohoff DF, Kramer BS (2010) Principles of cancer screening: lessons from history and study design issues. Semin Oncol 37:202–215. https://doi.org/10.1053/j.seminoncol.2010.05.006
doi: 10.1053/j.seminoncol.2010.05.006
pubmed: 20709205
pmcid: 2921618
He H et al (2021) Nonlinear relationship between age and likelihood of undergoing prostate-specific antigen testing, and the predictive factors of testing at different ages. Am J Mens Health 15:15579883211026516. https://doi.org/10.1177/15579883211026515
doi: 10.1177/15579883211026515
pubmed: 34167355
pmcid: 8246524
Kim DD et al (2022) Low-value prostate-specific antigen test for prostate cancer screening and subsequent health care utilization and spending. JAMA Netw Open 5:e2243449–e2243449. https://doi.org/10.1001/jamanetworkopen.2022.43449
doi: 10.1001/jamanetworkopen.2022.43449
pubmed: 36413364
pmcid: 9682424
Telesca D, Etzioni R, Gulati R (2008) Estimating lead time and overdiagnosis associated with PSA screening from prostate cancer incidence trends. Biometrics 64:10–19. https://doi.org/10.1111/j.1541-0420.2007.00825.x
doi: 10.1111/j.1541-0420.2007.00825.x
pubmed: 17501937
Etzioni R et al (2002) Overdiagnosis due to prostate-specific antigen screening: lessons from U.S. prostate cancer incidence trends. J Natl Cancer Inst 94:981–990. https://doi.org/10.1093/jnci/94.13.981
doi: 10.1093/jnci/94.13.981
pubmed: 12096083
Qian Z et al (2023) Investigating the racial gap in prostate cancer screening with prostate-specific antigen among younger men from 2012 to 2020. LID. https://doi.org/10.1093/jncics/pkad003
doi: 10.1093/jncics/pkad003
Conderino S et al (2022) The use of electronic health records to inform cancer surveillance efforts: a scoping review and test of indicators for public health surveillance of cancer prevention and control. BMC Med Inform Decis Mak 22:91. https://doi.org/10.1186/s12911-022-01831-8
doi: 10.1186/s12911-022-01831-8
pubmed: 35387655
pmcid: 8985310
Rauscher GH, Johnson TP, Cho YI, Walk JA (2008) Accuracy of self-reported cancer-screening histories: a meta-analysis. Cancer Epidemiol Biomarkers Prev 17:748–757. https://doi.org/10.1158/1055-9965.Epi-07-2629
doi: 10.1158/1055-9965.Epi-07-2629
pubmed: 18381468