PD09-07 THE ROLE OF PATIENT RACE AND ETHNICITY IN PREDICTING PHYSICIAN RECOMMENDATION OF PROSTATE-SPECIFIC ANTIGEN (PSA) TESTING
INTRODUCTION AND OBJECTIVES
A 2012 report by the US Preventive Service Task Force recommended against PSA-based screening among healthy men. African American men, however, have a higher incidence of, and mortality rate from, prostate cancer and may warrant more stringent screening. Uniform screening practices across races in accordance with the USPSTF statement may be detrimental the prognosis of men in high-risk groups. This study seeks to evaluate whether there was variability across categories of race in the proportion of men who were advised to have a PSA test by their physician.
METHODS
This cross-sectional study was performed using the 2012 Behavioral Risk Factor Surveillance System (BRFSS). Males under age 40 and females were excluded from the analysis. A subject's self-identified racial category as well as his response to whether or not he identified himself as Hispanic or Latino was used to operationalize “race”. Level of education, income, insurance status and number of reported primary physicians were included as confounders in our logistic regression analysis using STATA v13.4.
RESULTS
Among 134,262 men in the analytic sample with valid information about race and being advised to have a PSA checked, the majority (82%) identified themselves as “White”. Controlling for all other variables, “Black/African American” and “Hispanic” respondents had 1.51 (95% CI, 1.37-1.67) and 1.21 (95% CI, 1.08-1.35) the odds of being advised to have their PSA levels checked compared to “White” subjects, respectively, while “Asian” subjects only had 0.49 (95% CI, 0.40-0.60) the odds compared to “Whites”.
CONCLUSIONS
Among respondents to the 2012 BRFSS, “African American, Non-Hispanic” men were most likely to receive recommendation to have a PSA level checked compared to men of other races. This finding suggests that, in 2012, a population known to be at higher risk of developing and suffering morbidity/mortality from prostate cancer was more stringently counseled and screened than other populations of men without the same risk profile. Further investigation is warranted to elicit more specific reasons behind physician variation in offering PSA checks across difference races, ethnicities and demographic characteristics and follow-up analysis of 2014 BRFSS data available in the later part of 2015 will provide an interesting appraisal of any practice pattern changes that may have been implemented following the USPSTF policy statement release.
