Is Social Support From Family Associated With PSA Testing? An Exploratory Analysis Using the Health Information National Trends Survey (HINTS) 2005

2008 ◽  
Vol 4 (1) ◽  
pp. 50-59 ◽  
Author(s):  
Kamilah B. Thomas ◽  
Sean L. Simpson ◽  
Will L. Tarver ◽  
Clement K. Gwede

African American and White men have the highest rates of prostate cancer in the United States. Families represent important social contexts within which illness occurs.The purpose of this study is to explore whether prostate-specific antigen (PSA) testing is associated with instrumental and informational social support from family members among a sample of Black and White men aged 45 and older. Data from the 2005 Health Information National Trends Survey were analyzed using logistic regression. The dependent variable was having a PSA test within the past year or less. The independent variables consisted of selected demographic and family informational and instrumental social support variables. The statistically significant variables included age and having a family member with cancer. Additional studies to elucidate the mechanisms of social support from family for prostate cancer are needed.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17000-e17000
Author(s):  
Joon Yau Leong ◽  
Ruben Pinkhasov ◽  
Thenappan Chandrasekar ◽  
Oleg Shapiro ◽  
Michael Daneshvar ◽  
...  

e17000 Background: Disabled patients are a unique minority population that may have lower literacy levels and difficulty communicating with physicians. Furthermore, their knowledge for cancer prevention recommendations is unknown. Herein, we aim to compare prostate-specific antigen (PSA) testing rates and associated predictors among disabled men and non-disabled men in the USA. Methods: We performed a cross-sectional study utilizing the Health Information National Trends Survey (HINTS) to analyze factors predicting PSA testing rates in men with disabilities (disabled, deaf, blind). Multivariable logistic regression models were used to determine clinically significant predictors of PSA testing in men with disabilities compared to that of the healthy cohort. Results: A total of 782 (14.6%) disabled men were compared to 4,569 (85.4%) non-disabled men. Disabled men were older with a mean age of 65.0 ± 14.2 vs. 55.0 ± 15.9 years (p < 0.001). On multivariable analysis, after adjusting for all available confounders including race, age, geographical region, survey year, marital status, health insurance, healthcare provider, amongst others, men with any disability were less likely to undergo PSA screening (OR 0.772, 95% CI 0.623-0.956, p = 0.018). Variables associated with increased PSA screening rates included age, having a healthcare provider or health insurance, and living with a partner. Although prostate cancer detection rates were shown to be higher among disabled men, this did not reach statistical significance. Conclusions: Our data suggests that significant inequalities in PSA screening exist among men with disabilities in the USA, with disabled men, especially the deaf and the blind, being less likely to be offered PSA screening. There is a clear need to implement strategies to reduce existing gaps in the care of disabled men and strive to reach equality in PSA screening in this unique population.


Author(s):  
Ian M. Thompson

Overview: Prostate cancer is a ubiquitous disease, affecting as many as two-thirds of men in their 60s. Through widespread prostate-specific antigen (PSA) testing, increasing rates of prostate biopsy, and increased sampling of the prostate, a larger fraction of low-grade, low-volume tumors have been detected, consistent with tumors often found at autopsy. These tumors have historically been treated in a manner similar to that used for higher-grade tumors but, more recently, it has become evident that with a plan of active surveillance that reserves treatment for only those patients whose tumors show evidence of progression, very high disease-specific survival can be achieved. Unfortunately, the frequency of recommendation of an active surveillance strategy in the United States is low. An alternative strategy to improve prostate cancer detection is through selected biopsy of those men who are at greater risk of harboring high-grade, potentially lethal cancer. This strategy is currently possible through the use of risk assessment tools such as the Prostate Cancer Prevention Trial Risk Calculator ( www.prostate.cancer.risk.calculator.com ) as well as others. These tools can predict with considerable accuracy a man's risk of low-grade and high-grade cancer, allowing informed decision making for the patient with a goal of detection of high-risk disease. Ultimately, other biomarkers including PCA3, TMPRSS2:ERG, and [-2]proPSA will likely aid in discriminating these two types of cancer before biopsy.


2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Daniel W. Smith ◽  
Diliana Stoimenova ◽  
Khadijah Eid ◽  
Al Barqawi

Prostate cancer is one of the most prevalent cancers among men in the United States, second only to nonmelanomatous skin cancer. Since prostate-specific antigen (PSA) testing came into widespread use in the late 1980s, there has been a sharp increase in annual prostate cancer incidence. Cancer-specific mortality, though, is relatively low. The majority of these cancers will not progress to mortal disease, yet most men who are diagnosed opt for treatment as opposed to observation or active surveillance (AS). These men are thus burdened with the morbidities associated with aggressive treatments, commonly incontinence and erectile dysfunction, without receiving a mortality benefit. It is therefore necessary to both continue investigating outcomes associated with AS and to develop less invasive techniques for those who desire treatment but without the significant potential for quality-of-life side effects seen with aggressive modalities. The goals of this paper are to discuss the problems of overdiagnosis and overtreatment since the advent of PSA screening as well as the potential for targeted focal therapy (TFT) to bridge the gap between AS and definitive therapies. Furthermore, patient selection criteria for TFT, costs, side effects, and brachytherapy template-guided three-dimensional mapping biopsies (3DMB) for tumor localization will also be explored.


2019 ◽  
Vol 17 (5) ◽  
pp. 506-513 ◽  
Author(s):  
Brandon R. Mason ◽  
James A. Eastham ◽  
Brian J. Davis ◽  
Lance A. Mynderse ◽  
Thomas J. Pugh ◽  
...  

Prostate cancer (PCa) represents a significant source of morbidity and mortality for men in the United States, with approximately 1 in 9 being diagnosed with PCa in their lifetime. The role of imaging in the evaluation of men with PCa has evolved and currently plays a central role in diagnosis, treatment planning, and evaluation of recurrence. Appropriate use of multiparametric MRI (mpMRI) and MRI-guided transrectal ultrasound (MR-TRUS) biopsy increases the detection of clinically significant PCa while decreasing the detection of clinically insignificant PCa. This process may help patients with clinically insignificant PCa avoid the adverse effects of unnecessary therapy. In the setting of a known PCa, patients with low-grade disease can be observed using active surveillance, which often includes a combination of prostate-specific antigen (PSA) testing, serial mpMRI, and, if indicated, follow-up systematic and targeted TRUS-guided tissue sampling. mpMRI can provide important information in the posttreatment setting, but PET/CT is creating a paradigm shift in imaging standards for patients with locally recurrent and metastatic PCa. This article examines the strengths and limitations of mpMRI for initial PCa diagnosis, active surveillance, recurrent disease evaluation, and image-guided biopsies, and the use of PET/CT imaging in men with recurrent PCa. The goal of this review is to provide a rational basis for current NCCN Clinical Practice Guidelines in Oncology for PCa as they pertain to the use of these advanced imaging modalities.


2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 40-40
Author(s):  
Sandip M. Prasad ◽  
G. Caleb Alexander ◽  
Scott E. Eggener

40 Background: During the past decade, the incidence of prostate cancer in the United States has declined. We hypothesized this was related to lower rates of prostate-specific antigen (PSA) testing and sought to evaluate PSA testing rates nationally. Methods: Using the National Ambulatory Medical Care Survey, a nationally representative sample of outpatient visits in the United States, we analyzed rates of PSA testing in men age 40 years or older who visited PCPs or urologists from 1997 to 2008. Results: An estimated 26.6 million (95% CI: 24.8-28.4 million) PSA tests were ordered during 94.5 million (95% CI: 90.9-98.1 million) office visits to urologists and 95 million (95% CI: 87.5-102.8 million) tests were ordered during 1.17 billion (95% CI: 1.15-1.18 billion) visits to PCPs, with an annual increase of 3.4% and 6.0%, respectively (P=0.055 and P<0.001 for trend). After adjusting for year, race, ethnicity, region, insurance and provider type, testing by PCPs was more likely among older men and highest among men aged 60 to 69 years (reference: 40-49 years; OR 2.32, 95% CI: 1.88-2.85). Compared to men without a chronic medical condition, those with one chronic condition had greater odds of receiving a PSA test (OR 1.28, 95% CI: 1.08-1.52). Conclusions: Prostate cancer incidence has declined over the past decade despite increasing rates of office-based PSA testing by PCPs and urologists during the period. Increasing rates of PSA testing merit scrutiny, especially in men with limited life expectancies who are unlikely to benefit from screening.


1997 ◽  
Vol 25 (4) ◽  
pp. 234-242 ◽  
Author(s):  
Mary McNaughton Collins ◽  
Floyd J. Fowler ◽  
Richard G. Roberts ◽  
Joseph E. Oesterling ◽  
George J. Annas ◽  
...  

Prostate cancer has become a major health concern of male Americans. It is now the most common nondermatologic cancer and the second leading cause of cancer death among men. The incidence of detected prostate cancer rose rapidly in recent years, partly because of prostate-specific antigen (PSA) testing; it is only now tapering off. Screening for prostate cancer with PSA is widespread in the United States, yet controversial: the American Urological Association recommends PSA screening and the American Cancer Society recommends offering screening; however, the United States Preventive Services Task Force (USPSTF) and the American College of Physicians (ACP) recommend against routine screening; and the American Academy of Family Physicians believes that the decision to screen should be left to the patient.


2004 ◽  
Vol 171 (4S) ◽  
pp. 334-334
Author(s):  
Walter J. Simoneaux ◽  
Caleb B. Bozeman ◽  
Brett S. Carver ◽  
Donald A. Elmajian

2022 ◽  
Vol 77 ◽  
pp. 102093
Author(s):  
Thanya Pathirana ◽  
Rehan Sequeira ◽  
Chris Del Mar ◽  
James A. Dickinson ◽  
Bruce K. Armstrong ◽  
...  

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