ASPO Abstracts

Authors: Rhaisili Rosario, Victoria Berges, Geetanjali Kamath, Lina Jandorf, Kezhen Fei, Nina A. Bickell, MD, MPH

Category: Cancer Health Disparities
Conference Year: 2020

Abstract Body:
Purpose: With US Preventive Task Force prostate cancer (PCa) guideline changes & uncertainty as to what to do, we describe current experience with PCa screening practices in 3 neighborhoods with 1 high & 2 low rates of PCa. Methods: We surveyed residents from Central Harlem (CH) (n=480) and East Harlem (EH) (n=498), predominantly minority & poor neighborhoods & the Upper East Side (UES) (n=224), a predominantly white and wealthy neighborhood. Half our cohort (n=598) were randomly sampled from an academic medical center’s data warehouse. We asked men >40 years old, to capture those with a family history who might need to screen at a younger age, if a provider ever talked with them about the pros and cons of PSA screening. We compared rates of discussion of PSA testing by race, neighborhood, family history (FH) and access barriers (having a usual site of care for routine care; insurance) and modeled significant bivariate risk factors. Results: 189 men ages 40-69 responded of whom 22% were white (W,) 44% black (B) & 34% Hispanic (H). 18% had a + FH with no racial difference (22%W,13%B, 22%H; p=0.326). Overall, 58% (62/106) of men ages 55-69 had a PSA discussion with their provider, no different than the 56% of those with a positive family history. 72% of men who have a usual place for routine care report a discussion compared with 20% of those without (p<0.0002). Similarly, 66% of men with insurance report PSA discussion compared with 27% of uninsured men (p=0.02). Multivariate model (c=.69; p=0.004) found that lack of a regular care site (OR=0.12; 95%CI: 0.03-0.47) and lack of insurance (OR=0.22; 95%CI: 0.05-0.99) reduced likelihood of a PCa screening discussion; having a positive family history did not increase the chance of discussion (OR=1.14; 95%CI: 0.37-3.54). Neighborhood and race were not significant and dropped from the model. CH EH UES p Prostate Ca Incidence (per 100k)* 196 128 122 0.001 PSA Discussion % (among 55-69yr & 40-69yr w +FH) 63 56 56 0.7 *NYS Ca Registry Conclusions: Since the 2012 USPTF change in PCa screening guidelines, there is no difference in rates of discussion about PSA screening in neighborhoods with vastly different rates of prostate cancer incidence. We must increase efforts to address PCA screening among high risk men.

Keywords: Prostate Cancer Screening

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