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Tinsley S, Mahabadi N, Hamel L, Dyson G, Lutz M, Hamilton A, Powell I, Heath EI. A Ten Year Experience of Men's Health Events in a Socioeconomically Diverse City in the United States - Lessons Learned. J Community Health 2024:10.1007/s10900-024-01354-5. [PMID: 38643316 DOI: 10.1007/s10900-024-01354-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2024] [Indexed: 04/22/2024]
Abstract
Community-based health events provide an opportunity to increase knowledge, awareness, and screening for acute and chronic diseases among individuals living in a socioeconomically diverse community. Because there are limited reports of such events, here we describe our ten-year experience of annual men's health fairs. This retrospective study of the Michigan Institute of Urology Foundation evaluated Men's Health Events held in Detroit, Michigan, from 2012 to 2021. Over 10 years, 11,129 men were screened and > 100,000 screenings were performed. The majority of the attendees were African-American men (61%), had a college degree (67%) or a high school diploma (26%), and had an annual income of <$35K (47%) or $35-60 K (30%). From 2012 to 2021, participants who saw a doctor in the past year rose from 62 to 70%; the median age of men rose from 52 to 58; their median testosterone levels increased from 353 ng/dL to 412 ng/dL, and men with concerning prostate-specific antigen values (≥ 4 ng/mL) doubled from 5% to 10%. Among participants, 59% had cholesterol levels of < 200 mg/dL, 28% of 200-240 mg/dL, and 13% of > 240 mg/dL; 7% had glucose levels of < 70 mg/dL, 68% of 70-105 mg/dL, and 25% of > 105 mg/dL ; 24% had ≥ 140 mmHg systolic and 18% had ≥ 90 mmHg diastolic blood pressure. Our findings suggest that community health events are successful at attracting and screening diverse community members. Such events should emphasize screening of high-risk individuals for acute and chronic diseases and promote other health-related behaviors.
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Affiliation(s)
- Shane Tinsley
- Wayne State University School of Medicine, Detroit, MI, 48201, USA
| | | | - Lauren Hamel
- Wayne State University School of Medicine, Detroit, MI, 48201, USA
- Karmanos Cancer Institute, Detroit, MI, 48201, USA
| | - Gregory Dyson
- Wayne State University School of Medicine, Detroit, MI, 48201, USA
- Karmanos Cancer Institute, Detroit, MI, 48201, USA
| | - Michael Lutz
- Michigan Institute of Urology, Rochester, MI, 48309, USA
| | | | - Isaac Powell
- Wayne State University School of Medicine, Detroit, MI, 48201, USA
- Karmanos Cancer Institute, Detroit, MI, 48201, USA
| | - Elisabeth I Heath
- Wayne State University School of Medicine, Detroit, MI, 48201, USA.
- Karmanos Cancer Institute, Detroit, MI, 48201, USA.
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Leong JY, Chandrasekar T, Berlin A, Klaassen Z, Wallis CJ, Ahmad AE, Herrera-Caceres JO, Perlis N, Fleshner NE, Goldberg H. Predictors of prostate-specific antigen testing in men aged ≥55 years: A cross-sectional study based on patient-reported outcomes. Int J Urol 2020; 27:711-718. [PMID: 32476206 DOI: 10.1111/iju.14276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 04/29/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To examine the predictors of prostate-specific antigen discussion with a physician and prostate-specific antigen testing in men aged ≥55 years. METHODS Utilizing the USA Health Information National Trends Survey, 4th Ed., a cross-sectional study from 2011 to 2014 was carried out to analyze the factors predicting prostate-specific antigen testing and discussion in men ≥55 years. Associations between each covariate and prostate-specific antigen discussion/testing were determined. Multivariable logistic regression models were used to determine clinically relevant predictors of prostate-specific antigen discussion/testing. Due to multiple comparisons, the Bonferroni correction was used. RESULTS A total of 2731 men included in the Health Information National Trends Survey were analyzed. Several socioeconomic parameters were found to increase the likelihood of men aged ≥55 years to undergo prostate-specific antigen testing: living with a spouse, a higher level of education (college graduate or above), a higher income (>$50 000 annually) and previous history of any cancer. In contrast, current smokers were less likely to undergo prostate-specific antigen testing. Having a prostate-specific antigen discussion with a physician was more likely for men surveyed in 2014, for men who were living with a spouse, who had a higher annual income (>$50 000 annually) and those with a history of any cancer. CONCLUSIONS Significant inequalities in prostate-specific antigen testing and discussion exist among men in the USA, mainly driven by socioeconomic factors. Ideally, prostate-specific antigen testing and discussion should be based on relevant clinical factors with a shared decision-making approach for every man. Therefore, a better understanding of the socioeconomic factors influencing prostate-specific antigen testing/discussions can inform strategies to reduce existing gaps in care.
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Affiliation(s)
- Joon Yau Leong
- Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Thenappan Chandrasekar
- Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Alejandro Berlin
- Radiation Medicine Program, Princess Margaret Cancer Center, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.,Techna Institute, University Health Network, Toronto, Ontario, Canada
| | - Zachary Klaassen
- Division of Urology, Department of Surgery, Medical College of Georgia, Augusta University, Augusta, Georgia, USA.,Georgia Cancer Center, Augusta, Georgia, USA
| | - Christopher Jd Wallis
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, Toronto, Ontario, Canada
| | - Ardalan E Ahmad
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, Toronto, Ontario, Canada
| | - Jaime O Herrera-Caceres
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, Toronto, Ontario, Canada
| | - Nathan Perlis
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, Toronto, Ontario, Canada
| | - Neil E Fleshner
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, Toronto, Ontario, Canada
| | - Hanan Goldberg
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, Toronto, Ontario, Canada.,Department of Urology, SUNY Upstate Medical University, Syracuse, New York, USA
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Jeihooni AK, Kashfi SM, Hatami M, Avand A, Bazrafshan MR. The Effect of Educational Program Based on PRECEDE Model in Promoting Prostate Cancer Screening in a Sample of Iranian Men. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:161-172. [PMID: 28913671 DOI: 10.1007/s13187-017-1282-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Prostate cancer is one of the most prevalent diseases among men. This study aimed to assess the effect of educational program based on Predisposing, Reinforcing, and Enabling Constructs in Educational/Environmental Diagnosis and Evaluation (PRECEDE) model in promoting prostate cancer screening in a sample of Iranian men. This is a quasi-experimental study carried out on 300 men aged 40 to 70 (the subjects 150 experimental and 150 control groups) in Shiraz City, Fars Province, Iran, in 2016. The participants of the intervention group attended training based on the PRECEDE model. The study compared mean scores of knowledge, attitude, enabling factors, perceived social support, quality of life, general health, self-efficacy, and screening behaviors of the subjects before and 6 months after intervention in experimental and control groups. The mean age of experimental group was 56.45 ± 8.65, and the mean age of the control group was 55.64 ± 8.71 years (P = 0.521). The study showed that there was a significant increase in the mean score of knowledge, attitudes, perceived self-efficacy, enabling factors, perceived social support, quality of life, public health and screening behaviors of the experimental group; however, no significant change was observed in the mean score of knowledge, attitudes, self-efficacy, quality of life, general health, perceived social support, enabling factors, and screening behaviors of the control group. Our findings showed that the health education programs designed based on PRECEDE could positively affect prostate cancer screening behaviors of individuals by improving their knowledge level and attitude, enabling factors, perceived social support, quality of life, general health, and self-efficacy.
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Affiliation(s)
- Ali Khani Jeihooni
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Fasa, Iran.
| | - Seyyed Mansour Kashfi
- Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahmood Hatami
- Department of Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | - Abulqasim Avand
- Department of Language, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Mohammad-Rafi Bazrafshan
- Department of Nursing, School of Nursing, Larestan University of Medical Sciences, Larestan, Iran
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Barati M, Amirzargar MA, Bashirian S, Kafami V, Mousali AA, Moeini B. Psychological Predictors of Prostate Cancer Screening Behaviors Among Men Over 50 Years of Age in Hamadan: Perceived Threat and Efficacy. IRANIAN JOURNAL OF CANCER PREVENTION 2016; 9:e4144. [PMID: 27761205 PMCID: PMC5055754 DOI: 10.17795/ijcp-4144] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 12/23/2015] [Accepted: 05/30/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Prostate cancer is the fourth most common cancer worldwide and is the second most lethal cancer. OBJECTIVES The aim of this study was to investigate psychological predictors of prostate cancer screening behaviors among men over 50 years of age in Hamadan. MATERIALS AND METHODS This cross-sectional study was carried out on 200 men over 50 years of age in Hamadan, west of Iran. Participants were recruited with a cluster sampling method. The subjects completed a self-administered questionnaire including demographic characteristics, prostate cancer screening behaviors and psychological factors related to prostate cancer. Data was analyzed by SPSS-18 using chi-square, fisher exact test, and logestic regression. RESULTS According to the results, 8.5 and 7.5 percent of participants reported history of digital rectal exam and prostate-specific antigen test, respectively. Also, the subjects reported 18.5%, 49.3% and 50.3% of receivable scores of knowledge, perceived threat, and perceived efficacy of prostate cancer screening behaviors, respectively. There was a significant association between prostate cancer screening behaviors and age groups (P < 0.05). CONCLUSIONS The results showed that providing analytical studies in this field helps to surface the hidden aspects of this context and the health care providers and administrators will hopefully consider them in planning for identification of psychological factors, such as barriers and facilitators factors.
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Affiliation(s)
- Majid Barati
- Social Determinants of Health Research Center, Department of Public Health, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Mohammad Ali Amirzargar
- Urology and Nephrology Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Saeed Bashirian
- Social Determinants of Health Research Center, Department of Public Health, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Vahid Kafami
- Department of Public Health, School of Health, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Amir Abbas Mousali
- Department of Public Health, School of Health, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Babak Moeini
- Social Determinants of Health Research Center, Department of Public Health, Hamadan University of Medical Sciences, Hamadan, IR Iran
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Dickey SL, Cormier EM, Whyte J, Graven L, Ralston PA. Demographic, Social Support, and Community Differences in Predictors of African-American and White Men Receiving Prostate Cancer Screening in the United States. Public Health Nurs 2016; 33:483-492. [PMID: 26790837 DOI: 10.1111/phn.12245] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine demographic, social support, and community factors from a national dataset that influence African-American (AA) and White men to receive prostate cancer screening (PCS) via the Digital Rectal Exam (DRE) or Prostate Specific Antigen Test (PSA). DESIGN AND SAMPLE A cross-sectional secondary analysis from the National Health and Nutrition Examination Survey (NHANES) provided the sample of AA (N = 377) and White (N = 971) men over the age of 40 years. Regression analysis with confidence intervals was utilized to examine the factors associated with AA and White men receiving PCS. The Social Ecological Model provided the theoretical framework. MEASURES Questionnaires from the NHANES dataset provided data for this study. RESULTS Age, education, and access to health care was associated with AA and White men receiving the DRE. Income and church attendance was only associated with White men receiving the DRE. Only White men had an association of income with receiving the PSA test and only AA men had an association of marital status with receiving the PSA test. CONCLUSIONS Cultural evaluations of PCS behaviors among AA men are necessary to decrease the health disparity of prostate cancer among the AA population.
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Affiliation(s)
- Sabrina L Dickey
- College of Nursing, Florida State University, Tallahassee, Florida
| | - Eileen M Cormier
- College of Nursing, Florida State University, Tallahassee, Florida
| | - James Whyte
- College of Nursing, Florida State University, Tallahassee, Florida
| | - Lucinda Graven
- College of Nursing, Florida State University, Tallahassee, Florida
| | - Penny A Ralston
- Center on Better Health and Life for Underserved Populations, Florida State University, Tallahassee, Florida
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Gandhi PK, Gentry WM, Kibert JL, Lee EY, Jordan W, Bottorff MB, Huang IC. The relationship between four health-related quality-of-life indicators and use of mammography and Pap test screening in US women. Qual Life Res 2015; 24:2113-28. [PMID: 25804316 PMCID: PMC4531104 DOI: 10.1007/s11136-015-0968-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2015] [Indexed: 01/13/2023]
Abstract
PURPOSE Limited evidence is available to explain the role of four components of health-related quality of life (HRQoL) on breast and cervical cancer screening. The objective of this study was to determine the relationship between four HRQoL aspects and use of mammography and Pap test screening in US women. METHODS Data were obtained from the 2012 Behavioral Risk Factor Surveillance System (BRFSS). The outcome variables were receiving mammogram <2 versus ≥2 years in women aged 50-74 years, and receiving Pap test <3 versus ≥3 years in women aged 18-64 years. Eight logistic regression models were conducted to test the role of four HRQoL aspects (general health status, physical HRQoL, mental HRQoL, and activity limitation) on the two screening variables, after adjusting for covariates. Statistical analysis accounted for the complex sampling design of the BRFSS, and the a priori alpha error was set at p ≤ 0.05. RESULTS Among respondents, approximately 74 and 78 % of the women received mammography and Pap test, respectively. Three HRQoL aspects (general health status, physical HRQoL, and activity limitation) were significantly associated with mammography use (all p values < 0.05), whereas two HRQoL aspects (general health status and physical HRQoL) were significantly associated with Pap test (p values ≤ 0.05). All significant relationships demonstrated higher cancer screening rates among individuals with better HRQoL. CONCLUSIONS HRQoL is an important factor associated with use of mammography and Pap test. Future studies should explore the mechanisms associated with an individual's HRQoL and use HRQoL assessment as an avenue to influence adherence to use of mammography and Pap tests.
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Affiliation(s)
- Pranav K Gandhi
- Department of Pharmacy Practice, South College School of Pharmacy, 400 Goodys Lane, Knoxville, TN, 37922, USA,
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Tasci-Duran E, Koc S, Korkmaz M. Turkish social attitudes towards to cancer prevention: a health belief model study. Asian Pac J Cancer Prev 2015; 15:7935-40. [PMID: 25292090 DOI: 10.7314/apjcp.2014.15.18.7935] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
This research was planned to reveal society's attitude towards cancer and early diagnosis using the health belief model. This study was planned as descriptive research in Isparta. A random sample of n=256 individuals of both genders was recruited at the largest shopping center. As a means of collection tool, a survey consisted of two forms, the first designed for sociodemographic information and the second covering 29 questions suitable for the content of Health Belief Model. Of the participants, 66.8% were female and 33.2% were male, and the average age was 33.3±11.0 years. Some 46.1% partly thought that they may develop cancer, and 49.6% were afraid of this possibility. As many as 50% indicated that cancer is an issue that comes from Allah. A significant difference was found between not going for control unless feeling bad, and blood analysis for cancer screening (χ2=3.780 p= 0.03). It was seen that in an area with a high rate of cancer, people's awareness of cancer prevention and early diagnosis and attitudes towards these are insufficient.
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Affiliation(s)
- Emel Tasci-Duran
- Obstetrics and Gynecological Nursing Department, Health Sciences Faculty, Suleyman Demirel Universty, Isparta, Turkey E-mail :
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Jeihooni AK, Kashfi SM, kashfi SH, Heydarabadi AB, Imanzad M, Hafez AA. Factors associated with prostate cancer screening behavior among men over 50 in Fasa, Iran, based on the PRECEDE model. Electron Physician 2015; 7:1054-62. [PMID: 26120414 PMCID: PMC4477765 DOI: 10.14661/2015.1054-1062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 01/27/2015] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Prostate cancer is one of the most common and lethal cancers in the world. The incidence of prostate cancer has been increasing in recent years. The purpose of this study was to investigate factors associated with prostate cancer screening behaviors among men over 50 in Fasa, Iran, based on the PRECEDE model. METHODS In this cross-sectional study, 400 men over 50 were studied in Fasa, Iran. Data were collected via a questionnaire on demographic characteristics, such as age, number of children, occupation, education, marital status, smoking, and prostate cancer screening behaviors. Data were analyzed using SPSS software, version 16. Independent samples t-test and the Pearson Product Moment correlation coefficient were used for the statistical analyses. RESULTS Men in the study had little knowledge (34.11±8.22) and attitude (28.23±7.23) about prostate cancer and screening behavior. Their mean scores about prostate cancer, screening behavior, quality of life, and general health were moderate. The subjects had low self-efficacy and perceived social support. Their mean scores of enabling factors and screening behaviors were at a low level. Pearson correlation scores showed a significant correlation between cancer prostate screening behavior and demographic variables, such as age (p=0.04, r=0.136), occupation (p=0.01, r=0.121), educational level (p=0.02, r=0.211), and marital status of the subjects (p=0.01, r=0.112), but there were not significant correlations with the number of children (p=0.12, r=0.092) and smoking (p=0.09, r=0.002). The T-test results showed significant relationships between age, occupation, and education of the subjects, and the PRECEDE model structures were significant for predisposing factors, enabling factors, and reinforcing factors (p<0.05). CONCLUSION The prostate cancer screening behaviors in men over 50 in Fasa, Iran, were at a low level. Due to predisposing factors, such as the knowledge, attitudes, and beliefs of individuals, reinforcing factors can have an important role in the behaviors related to prostate screening, such as their families and health staffs as well as enabling factors, such as health financing, access to medicines and learning self-care. Educational interventions to improve these behaviors and the quality of life of these people seem essential.
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Affiliation(s)
- Ali Khani Jeihooni
- Department of Public Health, Fasa University of Medical Sciences, Fasa, Fars, Iran
| | - Seyyed Mansour Kashfi
- Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Seyyed hannan kashfi
- M.Sc. of Teaching in English, Faculty member of Larestan nursing school, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Masoumeh Imanzad
- School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Asghar Ashrafi Hafez
- Cancer Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Lee HY, Jung Y. Older Korean American men's prostate cancer screening behavior: the prime role of culture. J Immigr Minor Health 2014; 15:1030-7. [PMID: 23504334 DOI: 10.1007/s10903-013-9804-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
East and South Asian male immigrants show markedly low odds of prostate cancer screening as compared to U.S.-born men. However, knowledge about these immigrants' culture-based screening behavior and barriers to screening is extremely limited. This study investigates factors influencing receipt of prostate cancer screening among Korean American immigrant men, particularly investigating culture's impact on screening behaviors. Data were collected through a convenience and purposive sampling technique from 134 Korean American males aged 50 and older recruited in New York City. A structured questionnaire was used and cultural variables were measured by adopting items from Tang and colleagues' work. Approximately 60 % of the sample had received a prostate-specific antigen (PSA) test in their lifetime, and of these, about 66 % reported having done so in the previous 12 months. Logistic regression analysis revealed that a crisis-oriented intervention approach was associated with a substantially reduced likelihood of screening. A positive correlation was noted between the use of Eastern medicine and PSA test receipt. Further analysis revealed a significant interaction effect between use of Eastern medicine and age in predicting PSA test uptake. Culture-specific intervention strategies for increasing prostate cancer screening in this group are discussed, with particular attention to increasing pertinent health literacy. Health professionals should consider the cultural domain when working with Korean immigrant men in order to provide culturally competent care.
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Affiliation(s)
- Hee Yun Lee
- School of Social Work, University of Minnesota, Twin Cities,105 Peters Hall, 1404 Gortner Avenue, St. Paul, MN, 55108, USA,
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Hoebel J, Starker A, Jordan S, Richter M, Lampert T. Determinants of health check attendance in adults: findings from the cross-sectional German Health Update (GEDA) study. BMC Public Health 2014; 14:913. [PMID: 25185681 PMCID: PMC4167266 DOI: 10.1186/1471-2458-14-913] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 08/29/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Germany, adult health checks are carried out in the primary care setting for early detection of chronic conditions, such as cardiovascular diseases, diabetes, and kidney disease. This study aims to examine the social, behavioural, and health-related determinants of health check attendance among eligible adults in Germany. METHODS Data were derived from the cross-sectional German Health Update (GEDA) study, a national health survey among adults in Germany carried out by the Robert Koch Institute. Analyses were restricted to respondents with statutory health insurance aged 35 years or older (n = 26,555). Logistic regression models were fitted to estimate associations between health check attendance and factors selected on the basis of Andersen's Behavioral Model of Health Services Use. RESULTS After mutual adjustment, higher health check attendance was associated with a higher age, higher socioeconomic status, being married, stronger social support, physical activity, non-smoking, greater fruit and vegetable consumption, and higher use of outpatient care in both sexes. In women, higher attendance was related to alcohol consumption and having company health insurance (BKK) after multiple adjustment. In men, higher attendance was associated with better self-rated health after adjusting for all other factors. CONCLUSIONS The findings of this study suggest that people with an unfavourable risk factor profile, such as socioeconomically disadvantaged groups, smokers, physically inactive people, and persons with a low fruit and vegetable intake, are less likely to have health checks than those with a more favourable risk profile. Health checks carried out in the primary care setting should be evaluated for their effects on population health and health inequality.
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Affiliation(s)
- Jens Hoebel
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101 Berlin, Germany.
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Canaris GJ, Tape TG, Wigton RS. Thyroid disease awareness is associated with high rates of identifying subjects with previously undiagnosed thyroid dysfunction. BMC Public Health 2013; 13:351. [PMID: 23590562 PMCID: PMC3643833 DOI: 10.1186/1471-2458-13-351] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Accepted: 04/03/2013] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Conventional screening for hypothyroidism is controversial. Although hypothyroidism is underdiagnosed, many organizations do not recommend screening, citing low disease prevalence in unselected populations. We studied attendees at a thyroid health fair, hypothesizing that certain patient characteristics would enhance the yield of testing. METHODS We carried out an observational study of participants at a Michigan health fair that focused on thyroid disease. We collected patient-reported symptoms and demographics by questionnaire, and correlated these with the TSH values obtained through the health fair. RESULTS 794 of 858 health fair attendees participated. Most were women, and over 40% reported a family history of thyroid disease. We identified 97 (12.2%) participants with previously unknown thyroid dysfunction. No symptom or combination of symptoms discriminated between hypothyroid and euthyroid individuals. Hypothyroid and euthyroid participants in the health fair reported each symptom with a similar prevalence (p > 0.01), a prevalence which was very high. In fact, when compared with a previously published case-control study that reported symptoms, the euthyroid health fair participants reported a higher symptom prevalence (range 3.9% to 66.3%, mean 31.5%), than the euthyroid individuals from the case-control study (range 2% to 54%, mean 17.4%). CONCLUSIONS A high proportion of previously undiagnosed thyroid disease was identified at this health fair. We initially hypothesized symptoms would distinguish between thyroid function states. However, this was not the case in this health fair screening population. The prevalence of reported symptoms was similar and high in both euthyroid and hypothyroid participants. Because attendees were self-selected, it is possible that this health fair that focused on thyroid disease attracted participants specifically concerned about thyroid health. Despite the lack of symptom discrimination, the much higher prevalence of hypothyroidism in this study (12%) compared with the general population (<2%) suggests that screening may be appropriate and effective in certain circumstances such as thyroid health fairs.
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Affiliation(s)
- Gay J Canaris
- University of Nebraska Medical Center, College of Medicine, Omaha, NE, USA
| | - Thomas G Tape
- University of Nebraska Medical Center, College of Medicine, Omaha, NE, USA
| | - Robert S Wigton
- University of Nebraska Medical Center, College of Medicine, Omaha, NE, USA
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Health disparities in clinical practice patterns for prostate cancer screening by geographic regions in the United States: a multilevel modeling analysis. Prostate Cancer Prostatic Dis 2013; 16:193-203. [DOI: 10.1038/pcan.2013.3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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13
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A prospective study of socioeconomic status, prostate cancer screening and incidence among men at high risk for prostate cancer. Cancer Causes Control 2012; 24:297-303. [PMID: 23224323 DOI: 10.1007/s10552-012-0108-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Accepted: 11/15/2012] [Indexed: 11/27/2022]
Abstract
PURPOSE Higher socioeconomic status (SES) men are at higher risk of prostate cancer (PCa) diagnosis, an association commonly interpreted as a function of higher rates of prostate screening among higher SES men. However, the extent to which screening explains this association has not been well quantified. METHODS Within a Detroit area cohort of 6,692 men followed up after a benign prostate procedure, a case-control study was conducted of 494 PCa cases and controls matched on age, race, duration of follow-up, and date of initial benign finding; 2000 Census data were used in a principal component analysis to derive a single factor, labeled the neighborhood SES index (NSESI), representing zip code-level SES. RESULTS Among cases, higher SES was associated with a younger age at initial biopsy: -1.48 years (95 % CI, -2.32, -0.64) per unit NSESI. After adjustment for confounders and duration of follow-up, higher SES was associated with more PSA tests and DRE during follow-up; 9 % (95 % CI, 2, 16) and 8 % (95 % CI, 1, 15) more respectively, per unit NSESI. Higher SES was associated with a higher risk of PCa diagnosis during follow-up, multivariable adjusted OR = 1.26 per unit increase in NSESI (95 % CI, 1.04, 1.49). Further adjustment for screening frequency somewhat reduced the association between SES and PCa risk (OR = 1.19 per unit NSESI, 95 % CI, 0.98, 1.44). CONCLUSIONS Differences in screening frequency only partially explained the association between higher zip code SES and PCa risk; other health care-related factors should also be considered as explanatory factors.
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Patel K, Ukoli F, Liu J, Beech D, Beard K, Brown B, Sanderson M, Kenerson D, Cooper L, Canto M, Blot B, Hargreaves M. A community-driven intervention for prostate cancer screening in African Americans. HEALTH EDUCATION & BEHAVIOR 2012; 40:11-8. [PMID: 22508702 DOI: 10.1177/1090198111431275] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of the study was to assess the impact of an educational intervention on prostate cancer screening behavior and knowledge. Participants were 104 African American men, 45 years and older, who had not been screened for prostate cancer with a prostate-specific antigen and/or digital rectal exam within the past year. All participants received an intervention delivered by trained lay community educators using a prostate cancer educational brochure developed in collaboration with the community, with structured interviews preintervention and 3 months postintervention. The main study outcomes included prostate-specific antigen screening rates during the 3-month interval and knowledge, barriers to screenings, and decisional conflict around screening. Compared with the 46 men who did not get screened, the 58 participants who got screened were more likely to have greater than a high school education, annual household incomes ≥$25,000, and a family history of non-prostate cancer (p < .05). Average knowledge scores increased, and barriers to screening scores decreased, from preintervention to postintervention only for participants who had been screened (p < .05). The results of this study demonstrate the feasibility and efficacy of an academic institution collaborating with the African American community to develop a successful prostate cancer educational intervention, an approach that can be expanded to other cancers and other chronic diseases.
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Affiliation(s)
- Kushal Patel
- Meharry Medical College, Nashville, TN 37208-3599, USA.
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Avery KNL, Metcalfe C, Vedhara K, Lane JA, Davis M, Neal DE, Hamdy FC, Donovan JL, Blazeby JM. Predictors of attendance for prostate-specific antigen screening tests and prostate biopsy. Eur Urol 2012; 62:649-55. [PMID: 22244151 DOI: 10.1016/j.eururo.2011.12.059] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Accepted: 12/30/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND Little is known about factors influencing men's decisions to undergo screening and diagnostic tests for prostate cancer (PCa). OBJECTIVE Identify predictors of attendance for prostate-specific antigen (PSA) testing and prostate biopsy. DESIGN, SETTING, AND PARTICIPANTS Literature searches and interviews with men undergoing PSA testing and prostate biopsy formed the basis of a self-report questionnaire designed to identify predictors of health behaviour, which was completed by men eligible for PSA invitation and prostate biopsy. Multitrait scaling analyses established the final questionnaire content. This revised instrument was distributed to a new cohort of men before PSA testing and biopsy invitations were received. Ethical committee approval was obtained from Trent Multicentre Research Ethics Committee (MREC/01/4/025-21/06/2001). MEASUREMENTS Predictors of health behaviour and attendance rates for PSA test or prostate biopsy were measured. Associations between questionnaire scores and health behaviour (PSA and prostate biopsy attendance) were examined using logistic regression. RESULTS AND LIMITATIONS The provisional 49-item health behaviour questionnaire was completed by 468 of 810 men (57.8%). Multitrait scaling refined the questionnaire to 26 items in six scales (A: health benefits, B: threats to health, C: barriers to testing, D: health intentions, E: external influences, F: current general health). A total of 1455 of 2657 men (54.8%) completed the revised instrument before invitations for PSA test or biopsy were received; 395 (43.4%) and 434 (91.6%) attended. Strong associations between men's health intentions (scale D) and PSA and biopsy attendance (odds ratio: 1.56 or 3.67, respectively; p<0.001) were observed with modest associations between the other five scales and attendance for PSA testing. Average questionnaire response rates represent the major limitation of this study. CONCLUSIONS Knowledge and beliefs about PCa and testing predict men's intentions and attendance for PSA testing and prostate biopsy. Understanding men's health behaviour is important for the management of patients seeking PSA testing in general practice.
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Affiliation(s)
- Kerry N L Avery
- School of Social and Community Medicine, University of Bristol, Bristol, UK.
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Garmon Bibb SC, Padden DL, Ferguson W. Moderators of access and utilization of clinical preventive services in older adults. J Adv Nurs 2011; 68:335-48. [DOI: 10.1111/j.1365-2648.2011.05743.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lehto RH, Song L, Stein KF, Coleman-Burns P. Factors influencing prostate cancer screening in African American men. West J Nurs Res 2010; 32:779-93. [PMID: 20696846 DOI: 10.1177/0193945910361332] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
African American men have the highest prostate cancer incidence and mortality rates worldwide, but have lower screening rates compared with Caucasian men. The purpose of the study was to identify social ecological factors that affect screening behaviors in African American men, knowledge that could be integral to the design of culturally appropriate interventions. The exploratory study included 60 African American males recruited from the greater Detroit metropolitan area. Social ecological variables examined included age, marital status, presence of health insurance, education, health values and behaviors, physician trust, and perceived stress coping (John Henryism). Analyses included descriptives, chi-square tests, one-way ANOVAs, and logistic regression. Findings concluded that a parsimonious model consisting of two variables (age and health values) was predictive. African American males, > or =50 years, with higher positive health values were more likely to obtain screening. Findings imply the importance of health values and targeted educational and screening interventions for younger African American men.
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Affiliation(s)
- Rebecca H Lehto
- Michigan State University-College of Nursing, East Lansing, MI 48824, USA.
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Huncharek M, Haddock KS, Reid R, Kupelnick B. Smoking as a risk factor for prostate cancer: a meta-analysis of 24 prospective cohort studies. Am J Public Health 2009; 100:693-701. [PMID: 19608952 DOI: 10.2105/ajph.2008.150508] [Citation(s) in RCA: 190] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We evaluated the relationship between smoking and adenocarcinoma of the prostate. METHODS We pooled data from 24 cohort studies enrolling 21 579 prostate cancer case participants for a general variance-based meta-analysis. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated separately for mortality and incidence studies. We tested the robustness of effect measures and evaluated statistical heterogeneity with sensitivity analyses. RESULTS In the pooled data, current smokers had no increased risk of incident prostate cancer (RR = 1.04; 95% CI = 0.87, 1.24), but in data stratified by amount smoked they had statistically significant elevated risk (cigarettes per day or years: RR = 1.22; 95% CI = 1.01, 1.46; pack years of smoking: RR = 1.11; 95% CI = 1.01, 1.22). Former smokers had an increased risk (RR = 1.09; 95% CI = 1.02, 1.16). Current smokers had an increased risk of fatal prostate cancer (RR = 1.14; 95% CI = 1.06, 1.19). The heaviest smokers had a 24% to 30% greater risk of death from prostate cancer than did nonsmokers. CONCLUSIONS Observational cohort studies show an association of smoking with prostate cancer incidence and mortality. Ill-defined exposure categories in many cohort studies suggest that pooled data underestimate risk.
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Abstract
OBJECTIVE To examine the predictors of prostate cancer screening among immigrant men aged > or =50 years who hold legal permanent residency status. METHODS A modified version of the behavioral model of health services use for vulnerable populations. A logistic regression model was used to test predisposing, enabling and need factors related to prostate cancer screening among older immigrant men. RESULTS Region of origin, access to medical care, age, education and visa adjustment status were significant contributors to the multivariate model. DISCUSSION The important role played by respondents' access to medical care and culture in accessing prostate screening is discussed as well as the importance of respondents' visa adjustment status. CONCLUSION Practitioners working with immigrants should be cognizant of the role culture plays in preventive healthcare behaviors.
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Affiliation(s)
- Njeri Kagotho
- George Warren Brown School of Social Work, Washington University in St. Louis, Campus Box 1196, St. Louis, MO 63130, USA.
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Promotion of cancer family history awareness: Jameslink Cancer Risk Assessment Tool at community health fairs. J Genet Couns 2008; 17:274-82. [PMID: 18484172 DOI: 10.1007/s10897-007-9146-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2007] [Accepted: 12/16/2007] [Indexed: 10/22/2022]
Abstract
This article examines the impact of providing personalized familial cancer risk assessments with the Jameslink Cancer Risk Assessment Tool. Users of the Jameslink (N = 166) at eight community health fairs completed a survey including demographic, psychosocial and behavioral variables to better understand responses to the Jameslink. No differences were found between whites and those of other races for variables of interest, indicating suitability of the Jameslink for diverse populations. Those with higher Jameslink-assessed risk had higher perceived risk of cancer. Approximately half (53.8%) reported that they would speak to their physician about their Jameslink-assessed risk. A regression found Jameslink-assessed risk, cancer worry, and perceived risk of cancer predicted intentions to speak to a physician about their risk. In addition, open-ended data provided suggestions to improve the Jameslink. Changes in content and format were suggested; however most were happy with the program and encouraged its promotion. The lack of findings for differences as a function of race bolsters the use of computerized Cancer Risk Assessment Tools in diverse communities. The positive feedback of users and the close association between cancer risk assessment, perceived risk, and intention to speak to a physician are supportive of continued use and development of Cancer Risk Assessment Tools in the community to promote awareness of cancer risk.
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Sieverding M, Matterne U, Ciccarello L, Luboldt HJ. Prostatakarzinomfrüherkennung in Deutschland. Urologe A 2008; 47:1233-8. [DOI: 10.1007/s00120-008-1695-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Decision-making about PSA testing and prostate biopsies: a qualitative study embedded in a primary care randomised trial. Eur Urol 2007; 53:1186-93. [PMID: 17709169 DOI: 10.1016/j.eururo.2007.07.040] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2007] [Accepted: 07/30/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The overall aim was to increase understanding of men's decision-making about prostate-specific antigen (PSA) testing and subsequent biopsy. METHODS This qualitative interview study was nested within the primary care-based Prostate Testing for Cancer and Treatment (ProtecT) trial in nine United Kingdom areas (ISRCTN number: 20141297). Fifty-eight men aged 50-69 yr (mean: 62 yr), accepting (n=14) or not responding (n=7) to invitations for PSA testing and accepting (n=24) or refusing (n=13) prostate biopsy were interviewed. RESULTS In this study, men accepting PSA testing and biopsy reported positively on their experiences, regardless of the final outcome. PSA testing was considered routine and biopsy acceptable to most men. Men both responding and not responding to PSA testing often perceived themselves to be at low risk for prostate cancer. Men refusing biopsy also tended to perceive themselves to be at low risk and many were anxious about the test itself. Misunderstandings about the relationship between urinary symptoms and risk of prostate cancer were identified. CONCLUSIONS Most men found PSA testing and biopsy acceptable, but perceptions of risk were not always accurate and the provision of more tailored information may help facilitate informed decision-making.
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Watson E, Hewitson P, Brett J, Bukach C, Evans R, Edwards A, Elwyn G, Cargill A, Austoker J. Informed decision making and prostate specific antigen (PSA) testing for prostate cancer: a randomised controlled trial exploring the impact of a brief patient decision aid on men's knowledge, attitudes and intention to be tested. PATIENT EDUCATION AND COUNSELING 2006; 63:367-79. [PMID: 16875796 DOI: 10.1016/j.pec.2006.05.005] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2006] [Revised: 04/27/2006] [Accepted: 05/01/2006] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To examine the impact of a brief patient decision aid (pDA) on men's knowledge, attitudes and intention to have a prostate specific antigen (PSA) test. To explore the important predictors of intention to be tested in men who received the brief pDA. METHODS A brief pDA designed to facilitate informed decision-making for men considering PSA testing was developed for the NHS Prostate Cancer Risk Management Programme. Men aged 40-75 years selected from 11 General Practices in England and Wales were randomised to receive either a mailed copy of the brief pDA and a questionnaire (intervention group), or a questionnaire alone (control group). The questionnaire assessed knowledge, attitudes, perceived risk and intention to have a PSA test and, for the intervention group, their perceptions of the brief pDA. RESULTS Nine hundred and ninety of the men who were eligible for the study returned completed questionnaires (response rate=54%). Men who received the brief pDA had significantly higher knowledge scores (p<0.0001) and less positive attitudes (p<0.0001) regarding PSA testing than men in the control group. There was no significant difference between the two groups in intention to be tested within the next 12 months. 87% of men found the brief pDA was easy to read, 94% considered it contained about the right amount of detail and 94% felt the information was presented in a balanced way. Multivariate analysis identified perceived risk (p<0.0001), perceived benefits of PSA testing (p<0.0001), knowledge (p=0.004), attitude (p=0.007) and age (p=0.01) as the most important independent predictors of intention to be tested amongst men in the intervention group. CONCLUSION The brief pDA was shown to dramatically increase men's knowledge of the benefits and risks of the PSA test. Men who received the brief pDA were significantly less positive about the PSA test, although there was no difference between the two groups regarding their intention to be tested within the next year. PRACTICE IMPLICATIONS This brief pDA could serve as an acceptable and low cost adjunct to counselling by the General Practitioner (GP), and should promote informed decision making regarding the PSA test. Further research is required to ascertain the utility of the decision aid during the consultation.
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Affiliation(s)
- Eila Watson
- Cancer Research UK Primary Care Education Research Group, Department of Primary Health Care, University of Oxford, Old Rd Campus, Headington, Oxford OX3 7LF, United Kingdom.
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Fowke JH, Signorello LB, Underwood W, Ukoli FAM, Blot WJ. Obesity and prostate cancer screening among African-American and Caucasian men. Prostate 2006; 66:1371-80. [PMID: 16752375 DOI: 10.1002/pros.20377] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Differential prostate-specific antigen (PSA) testing practices according to obesity-related comorbid conditions may contribute to inconsistent results in studies of obesity and prostate cancer. We investigated the relationship between obesity and PSA testing, and evaluated the role of prior diagnoses and disease screening on PSA testing patterns. METHODS Men, 40 and 79 years old and without prior prostate cancer were recruited from 25 health centers in the Southern US (n = 11,558, 85% African-American). An extensive in-person interview measured medical and other characteristics of study participants, including PSA test histories, weight, height, demographics, and disease history. Odds ratios (OR) and (95% confidence intervals) from logistic regression summarized the body mass index (BMI) and PSA test association while adjusting for socio-economic status (SES). RESULTS BMI between 25 and 40 was significantly associated with recent PSA testing (past 12 months) (OR(25.0-29.9) = 1.23 (1.09, 1.39); OR(30-34.9) = 1.36 (1.18, 1.57); OR(35.0-39.9) = 1.44 (1.18, 1.76); OR(> or =40) = 1.15 (0.87, 1.51)). Prior severe disease diagnoses, such as heart disease, did not influence the obesity and PSA test association. However, adjustment for prior high blood pressure or high cholesterol diagnoses reduced the BMI-PSA testing associations. Physician PSA test recommendations were not associated with BMI, and results did not appreciably vary by race. CONCLUSIONS Overweight and obese men were preferentially PSA tested within the past 12 months. BMI was not associated with physician screening recommendations. Data suggest that clinical diagnoses related to obesity increase clinical encounters that lead to preferential selection of obese men for prostate cancer diagnosis. This detection effect may bias epidemiologic investigations of obesity and prostate cancer incidence.
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Affiliation(s)
- Jay H Fowke
- Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee, USA.
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