scholarly journals Digital rectal examination and its associated factors in the early detection of prostate cancer: a cross-sectional population-based study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Samara Carollyne Mafra Soares ◽  
Marianna de Camargo Cancela ◽  
Arn Migowski ◽  
Dyego Leandro Bezerra de Souza
Keyword(s):  
Public Health ◽  
Prostate Cancer ◽  
Health Insurance ◽  
Early Detection ◽  
Health Services ◽  
Urban Areas ◽  
Private Health Insurance ◽  
Digital Rectal Examination ◽  
Positive Association ◽  
Population Based

Abstract Background Digital rectal examination (DRE) is one of the most common strategies for prostate cancer early detection. However, the use for screening purposes has a controversial benefit and potential harms can occur due to false-positive results, overdiagnosis and overtreatment. The objective of this study is to calculate the prevalence and identify factors associated with the receipt of DRE in Brazilian men. Methods We selected men older than 40 from a nationwide population-based survey (13,625 individuals) excluding those with prostate cancer diagnosis. Information was extracted from the most recent database of the Brazilian National Health Survey (PNS 2013). Statistical analysis was carried out to calculate incidence rate ratios, with 95% confidence intervals and p values, through multivariate analysis with Poisson regression and robust variance. Results Men having private health insurance (63.3%; CI = 60.5–66.0) presented higher prevalence of DRE than those in the public health system (41.6%; CI = 39.8–43.4). The results show a positive association between DRE and men having private health insurance, aged 60–69, living with a spouse, never smokers, and living in urban areas. Among public health services users, this positive association was observed among men aged 70–79, living with a spouse, having bad/very bad health self-perception, abstainers, ex-smokers, with undergraduate studies, presenting four or more comorbidities, and residing in urban areas. Conclusions Prostate cancer screening with DRE is quite frequent in Brazil, specially among men with private health plans and better access to health services, healthier lifestyle and at more advanced ages, characteristics which increase the risk of overdiagnosis and overtreatment.

scholarly journals Identifying Risk Profiles of Malignant Prostate Cancer Surgical Delay Using a Person-Centered Approach to Understand Prostate Cancer Disparities: The Constellation of Health Determinants Using Latent Class Analysis on Cancer Registry Data

2020 ◽  
Vol 14 (6) ◽  
pp. 155798832098428
Author(s):  
Francisco A. Montiel Ishino ◽  
Claire Rowan ◽  
Rina Das ◽  
Janani Thapa ◽  
Ewan Cobran ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Health Insurance ◽  
Latent Class Analysis ◽  
Cancer Registry ◽  
High Probability ◽  
Private Health Insurance ◽  
Latent Class ◽  
Class Analysis ◽  
Risk Profiles ◽  
Surgical Delay

Surgical prostate cancer (PCa) treatment delay (TD) may increase the likelihood of recurrence of disease, and influence quality of life as well as survival disparities between Black and White men. We used latent class analysis (LCA) to identify risk profiles in localized, malignant PCa surgical treatment delays while assessing co-occurring social determinants of health. Profiles were identified by age, marital status, race, county of residence (non-Appalachian or Appalachian), and health insurance type (none/self-pay, public, or private) reported in the Tennessee Department of Health cancer registry from 2005 to 2015 for adults ≥18 years ( N = 18,088). We identified three risk profiles. The highest surgical delay profile (11% of the sample) with a 30% likelihood of delaying surgery >90 days were young Black men, <55 years old, living in a non-Appalachian county, and single/never married, with a high probability of having private health insurance. The medium surgical delay profile (46% of the sample) with a 21% likelihood of delay were 55–69 years old, White, married, and having private health insurance. The lowest surgical delay profile (42% of the sample) with a 14% likelihood of delay were ≥70 years with public health insurance as well as had a high probability of being White and married. We identified that even with health insurance coverage, Blacks living in non-Appalachian counties had the highest surgical delay, which was almost double that of Whites in the lowest delay profile. These disparities in PCa surgical delay may explain differences in health outcomes in Blacks who are most at-risk.

Digital rectal examination is barrier to population-based prostate cancer screening

Urology ◽  
2005 ◽  
Vol 65 (6) ◽  
pp. 1137-1140 ◽  
Author(s):  
Harris M. Nagler ◽  
Eric W. Gerber ◽  
Peter Homel ◽  
Joseph R. Wagner ◽  
Jennifer Norton ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Prostate Cancer Screening ◽  
Digital Rectal Examination ◽  
Population Based ◽  
Rectal Examination

Comparing Two Modalities of Screening for Prostate Cancer: Digital Rectal Examination + Transrectal Ultrasonography Vs. Prostate-Specific Antigen

1995 ◽  
Vol 81 (4) ◽  
pp. 225-229 ◽  
Author(s):  
Stefano Ciatto ◽  
Rita Bonardi ◽  
Antonia Mazzotta ◽  
Claudio Lombardi ◽  
Roberto Santoni ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Early Detection ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Transrectal Ultrasonography ◽  
Attendance Rate ◽  
Predictive Values ◽  
Rectal Examination ◽  
Biopsy Rate

Aims and background To evaluate the performance and feasibility of screening for prostate cancer by comparing screening modalities. Methods Prospective study of two comparable cohorts of healthy resident males aged 60 to 75 years. Screening attenders in the two invited cohorts were screened either by digital rectal examination (DRE) and transrectal ultrasonography (TRUS), or by serum prostate-specific antigen determination (PSA: cutoff 4 ng/ml). Attendance and biopsy rates, predictive values, prevalence of screen-detected cancers, as well as screening costs were determined, and the efficiency of the two screening modalities was compared. Results 1425 subjects were screened by DRE + TRUS. Attendance rate was 33.7%, the biopsy rate was 2.7%, and the prevalence of detected cancers was 1.82%. A total of 1315 subjects was screened by PSA. Attendance rate was 66.9%, the biopsy rate was 2.8%, and the prevalence of detected cancers was 1.67%. Screen-detected cancer stage was more favorable than observed in clinical practice, and early detection was evident, with the prevalence/incidence ratio higher than 10:1 in both programs. The cost per subject screened was about 34,000 Lire for DRE + TRSU and about 30,000 Lire for PSA program. Conclusions The study confirms that early detection of prostate cancer is possible and that screening is practically feasible. Both screening modalities achieved comparable results as regards early detection, but screening by PSA had a higher compliance and lower costs. PSA seems the ideal test to be used in prospective controlled studies aimed at demonstrating screening efficacy.

scholarly journals Pattern and Presentation of Prostate Cancer at a Referral Centre in the Brong Ahafo Region of Ghana; A 10-Year Retrospective Study

2020 ◽  
Vol 5 (1) ◽  
Keyword(s):  
Public Health ◽  
Prostate Cancer ◽  
Perineural Invasion ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Screening Tools ◽  
High Incidence ◽  
Prostate Diseases ◽  
Brong Ahafo Region ◽  
Brong Ahafo

Introduction: Prostate cancer is gradually reaching a very high incidence in Africa, especially in the Sub-Saharan region. Understanding the dynamics in occurrence of the disorder is one approach to developing effective public health programmes and interventions that will help curb the rising incidence. Objective: This study was aimed at providing comprehensive and credible data on prostate cancer by assessing the incidence, trend and presentation in the Brong Ahafo Region of Ghana. We sought to provide region-specific hardcore data that will help to assess the issue and provide remedies. Methodology: All prostate disease cases recorded from the year 2009 to 2018 were retrospectively reviewed. Subjects from 40 years and above were eligible for screening. Diagnostic and screening tools for prostate cancer at the study site include family history, serum prostate specific antigen (PSA) test, digital rectal examination, urological ultrasound scan and histopathology (biopsy). Age, PSA values and year of screening/diagnosis were also retrieved from patient folders for the study. Histological findings and parameters considered in the study included diagnosis, carcinoma grading, perineural invasion (PNI) and percentage of affected tissues (%TA). Results: Prostate cancer cases were 369, representing 36.4% of the 1,014 prostate diseases studied. The highest annual incidence was recorded in 2014 with 51 cases (13.8%). The ages of patients ranged from 46 to 101 years with a modal age range of 70 - 79 years and a mean ± SD of 72.2 ± 9.8. The mean PSA value recorded was 37.1ng/ml (±107.3) with predominance in the 11 - 20.9 ng/ml range. Majority of Group Grade 2-5 (79%) constituted progressive prostate cancer. There was no significant correlation (p = 0.091) between grade of prostate cancer and perineural invasion. Conclusion: There is a high incidence of prostate cancer in the Brong Ahafo Region of Ghana (32 per 100,000), predominantly advanced prostatic carcinoma. Reported cases also show high %TA (38.7%) and PNI (38.0%). Early screening for prostate diseases should be encouraged to avoid progression to advanced stage and public health interventions are needed to address some of these issues.

scholarly journals Utilization of public health care by people with private health insurance: a systematic review and meta-analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Congcong Zhang ◽  
Chenwei Fu ◽  
Yimin Song ◽  
Rong Feng ◽  
Xinjuan Wu ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Health Care ◽  
Health Insurance ◽  
Private Health Insurance ◽  
Meta Analysis ◽  
Public Health Care

Access to health care for people with multiple sclerosis

2007 ◽  
Vol 13 (4) ◽  
pp. 547-558 ◽  
Author(s):  
S.L. Minden ◽  
D. Frankel ◽  
L. Hadden ◽  
D.C. Hoaglin
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Insurance ◽  
Health Services ◽  
Access To Health Care ◽  
Prescription Medication ◽  
Population Based ◽  
Care Providers ◽  
Usual Source ◽  
Access To Health

The Sonya Slifka Longitudinal Multiple Sclerosis (MS) Study follows a population-based cohort of approximately 2000 people with MS to study demographic and clinical characteristics, use and cost of health services, provider and treatment characteristics, neurological, economic, and psychosocial outcomes. We examined key indicators of access to health care and found that the majority of participants had health insurance, a usual source of care, and access to specialty care. Nevertheless, 3.8% did not have health insurance which, with application of sampling weights, corresponds to approximately 7000 people with MS in the US population. Even with insurance, population-based estimates indicated that substantial numbers of people with MS have plans that pay nothing toward prescription medication, limit their access to specialists, and restrict their choice of hospitals and providers. Some 9% of the sample, corresponding to 15 800 people with MS, did not have a usual source of MS care; 11.8% or 17 300 people did not have a usual source of general health care; and 31% or 57 400 people did not see the specialists that they or their physicians wanted them to see. Further, 10.5% or 19 400 people reported difficulty obtaining prescription medication, 4.1% or 7600 people encountered obstacles accessing medical care, and 2.4% or 4500 people could not obtain the mental health services they needed. Finally, out-of-pocket health care expenditures were twice those found for the general population. Two-thirds of study participants (representing almost 70 000 people) chose their MS care providers because they were neurologists or MS specialists, creating a demand that almost certainly exceeds current supply. Multiple Sclerosis 2007; 13: 547-558. http://msj.sagepub.com

Screening for prostate cancer

2017 ◽  
Author(s):  
Fritz H. Schröder
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Early Detection ◽  
Secondary Prevention ◽  
Current Knowledge ◽  
Age Groups ◽  
Population Based ◽  
High Rate ◽  
High Quality ◽  
Prostate Cancer Mortality

Screening for a disease must be clearly defined and differentiated from early detection. ‘Screening’ refers to the application of tests to the whole population or to defined segments such as males within certain defined high risk age groups. If applied in such a fashion ‘screening’ for prostate cancer may also be described epidemiologically as ‘secondary prevention’. While high-quality randomized studies show that screening reduces prostate cancer mortality by 21–44%, there is wide agreement that the introduction of population-based screening is at present premature because harms, mainly the high rate of overdiagnosis seen currently outweighs the benefits. This chapter attempts to put current knowledge into perspective with a set of recognized prerequirements for the application of screening, established by Wilson and Jungner in 1968.

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