Health Services Research

PV QA 3 - Poster Viewing Q&A 3

TU_37_2960 - Prostate Cancer Screening Rates in Black and White Men Across the US Before and After 2012 USPSTF Guidelines

Tuesday, October 23
1:00 PM - 2:30 PM
Location: Innovation Hub, Exhibit Hall 3

Prostate Cancer Screening Rates in Black and White Men Across the US Before and After 2012 USPSTF Guidelines
D. P. Lindsay, R. Basak, and R. C. Chen; The University of North Carolina at Chapel Hill, Chapel Hill, NC

Purpose/Objective(s): Prostate cancer screening, while controversial, may be more likely to benefit black than white men due to increased incidence and aggressiveness of prostate cancer in the African American population. In 2012, the USPSTF recommended against all prostate cancer screening. We examined the impact of this recommendation on racial differences in PSA screening rates.

Materials/Methods: Results from the National Health Interview Survey (NHIS), population-based and designed to reflect health care patterns across the US, were analyzed for years 2008, 2010, 2013, and 2015. Multivariable analysis assessed factors associated with PSA screening, including race, year of survey, age, education, region, marriage status, insurance, and comorbidities.

Results: 26,996 men were included, and 15.7% were black. In younger men age 40-49, more black than white men reported PSA screening in the prior 2 years across all years (Table); for older men age 60+, more white men reported PSA screening in all years. PSA screening rates declined for both white and black men after 2012. Using a validated life expectancy scale for NHIS, we created a subgroup of men age 65+ with less than 9-year life expectancy; screening rates were 42.6% for black and 46.4% for white men in this group in 2015. On multivariable analysis, year 2008 and 2010 were associated with higher PSA screening rates – showing the effect of the 2012 USPSTF guidelines. Race was not significantly associated with screening (p=.36). Older age was associated with less screening.

Conclusion: The decline of PSA screening after the 2012 USPSTF guidelines affected white and black men similarly. However, there remains significant overscreening in men with limited life expectancy. Future research needs to define the potential differential benefit of screening by race in order to inform guidelines and clinical decision-making.

Year of Survey:

2008 2010 2013 2015
Age Race % Screened
40-49 Black 22.5 20.1 17.9 18.2
White 18.7 15.8 14.1 14.6
50-59 Black 35.2 39.6 36.1 35.3
White 40.0 39.0 31.9 36.3
60-69 Black 54.5 57.2 43.9 49.8
White 61.0 63.1 53.9 56.0
70+ Black 55.8 55.3 45.9 47.2
White 63.8 61.8 56.9 55.9

Author Disclosure: D.P. Lindsay: None. R. Basak: None. R.C. Chen: Research Grant; Accuray Inc. Consultant; Accuray Inc.

Daniel Lindsay, MD, BS

The University of North Carolina

Disclosure:
No relationships to disclose.

Presentation(s):

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