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VanderVeer-Harris N, Zippi ZD, Patel DP, Manoharan M, Caso JR, Vaidean GD. Racial and ethnic disparities in prostate cancer screening following the 2018 US Preventive Services Task Force recommendation statement. J Med Screen 2024:9691413241248052. [PMID: 38646707 DOI: 10.1177/09691413241248052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
OBJECTIVE In 2018, the United States Preventive Services Task Force promoted shared decision making between healthcare provider and patient for men aged 55 to 69. This study aimed to analyze rates of prostate-specific antigen (PSA) testing across racial and ethnic groups following this new recommendation. METHODS A secondary analysis was conducted of the 2020-2021 Behavioral Risk Factor Surveillance System database to assess men aged 55 or older without a history of prostate cancer. We defined four race-ethnicity groups: non-Hispanic Whites (NHWs), non-Hispanic Blacks (NHBs), Hispanics, and Other. The primary outcome was the most recent PSA test (MRT), defined as the respondent's most recent PSA test occurring pre-2018 or post-2018 guidelines. Logistic regression adjusted for covariates including age, socioeconomic status factors, marital status, smoking history, and healthcare access factors. RESULTS In the age 55 to 69 study sample, NHW men had the greatest proportion of MRT post-2018 guidelines (n = 15,864, 72.5%). NHB men had the lowest percentage of MRT post-2018 guidelines (n = 965, 66.6%). With NHW as referent, the crude odds of the MRT post-2018 guidelines was 0.68 (95% confidence interval (CI) = 0.53-0.90) for NHB. The maximally adjusted odds ratio was 0.78 (0.59-1.02). CONCLUSIONS We found that NHB aged 55 to 69 reported decreased rates of PSA testing after 2018 when compared to NHW. This was demonstrated on crude analysis but not after adjustment. Such findings suggest the influence of social determinants of health on preventative screening for at-risk populations.
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Affiliation(s)
| | - Zachary D Zippi
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
| | - Dev P Patel
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
| | | | - Jorge R Caso
- Miami Cancer Institute, Baptist Health South Florida, Miami, Florida, USA
| | - Georgeta D Vaidean
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
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Bataba E, Babcock K, Isensee KA, Eldhose B, Kohaar I, Chesnut GT, Dobi A. Germline Mutations and Ancestry in Prostate Cancer. Curr Oncol Rep 2024; 26:175-180. [PMID: 38265515 PMCID: PMC10891190 DOI: 10.1007/s11912-024-01493-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2024] [Indexed: 01/25/2024]
Abstract
PURPOSE OF REVIEW Prostate cancer is the most frequently diagnosed non-cutaneous malignancy of men in the USA; notably, the incidence is higher among men of African, followed by European and Asian ancestry. Germline mutations and, in particular, mutations in DNA damage repair genes (DDRGs) have been implicated in the pathogenesis of prostate cancer. This review intends to discuss the implication of ancestry on prostate cancer, specifically in regard to lack of diversity in genomic and genetic databases and the ability of providers to properly counsel patients on the significance of cancer genetic results. RECENT FINDINGS Ancestral differences in prostate cancer-associated DDRG germline mutations are increasingly recognized. Guidelines for treatment by the National Comprehensive Cancer Network® (NCCN®) support germline testing in certain patients, and a myriad of genetic testing panels for DDRG mutations are now available in clinical practice. However, the consensus among providers on what genes and mutations to include in the genetic tests has evolved from experience from men of European ancestry (EA). Gaps in ancestry-informed clinical practice exist in genetic risk assessment, implementation of screening, counseling, guiding recommendations, treatment, and clinical trial enrollment. The lack of diversity in tumor genomic and genetic databases may hinder ancestry-specific disease-predisposing alterations from being discovered and targeted in prostate cancer and, therefore, impede the ability of providers to accurately counsel patients on the significance of cancer genetic test results.
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Affiliation(s)
- Eudoxie Bataba
- Walter Reed National Military Medical Center, Bethesda, MD, 20889, USA
| | - Kevin Babcock
- Walter Reed National Military Medical Center, Bethesda, MD, 20889, USA
| | - Kathryn A Isensee
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| | - Binil Eldhose
- Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery at the Uniformed Services University of the Health Sciences, 6720A Rockledge Drive Suite 300, Bethesda, MD, 20817, USA
- Henry Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD, 20817, USA
| | - Indu Kohaar
- Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery at the Uniformed Services University of the Health Sciences, 6720A Rockledge Drive Suite 300, Bethesda, MD, 20817, USA
- Henry Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD, 20817, USA
- Cancer Biomarkers Research Group, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Rockville, MD, 20850, USA
| | - Gregory T Chesnut
- Walter Reed National Military Medical Center, Bethesda, MD, 20889, USA
- Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery at the Uniformed Services University of the Health Sciences, 6720A Rockledge Drive Suite 300, Bethesda, MD, 20817, USA
| | - Albert Dobi
- Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery at the Uniformed Services University of the Health Sciences, 6720A Rockledge Drive Suite 300, Bethesda, MD, 20817, USA.
- Henry Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD, 20817, USA.
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