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Gercek O, Demirbas A, Topal K, Eren B, Yazar VM. The effect of health literacy on patient compliance in patients to whom prostate biopsies were recommended. BMC Urol 2024; 24:172. [PMID: 39134976 PMCID: PMC11318269 DOI: 10.1186/s12894-024-01562-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 08/06/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Transrectal ultrasound-guided prostate biopsy (TRUS-Bx) is the gold standard diagnostic method for prostate cancer. In people with low health literacy, accurate and early diagnosis rates decrease, making it difficult to maintain health and compliance with treatment. In our study, we investigated how health literacy and sociocultural parameters affected compliance and awareness in patients with suspected prostate cancer, for whom TRUS-Bx was planned. METHODS In the study, 98 male patients aged 50-80 years, recommended for TRUS-Bx, were included in our study. The data including age, prostate-specific antigen, prostate volume, digital rectal examination findings, education leveland area of residence of the patients included in the study were recorded. Health Literacy Survey-Turkey- Questionnaire 47 and Turkish Health Literacy Scale-32 forms were completed by the patients who agreed to participate in the study, and their scores were recorded. Patients scheduled for TRUS-Bx were divided into two groups: those who attended their appointments and underwent the biopsy, and those who did not attend their scheduled appointments. The effect of health literacy and other parameters on the TRUS-Bx requirement was examined between the two groups. Furthermore, 52 patients who underwent TRUS-Bx were divided into two groups as malignancy (malignant) detected and not-detected (benign) patients according to the pathology results, and the parameters were analyzed separately for these groups. RESULTS The education level of the patients who underwent the TRUS-Bx procedure was found to be statistically higher (p = 0.026). Health Literacy Survey-Turkey- Questionnaire 47 and Turkish Health Literacy Scale-32 scores were statistically significantly higher in the TRUS-Bx group (p = 0.001, p < 0.001, respectively). In the logistic regression analysis, education level, Health Literacy Survey-Turkey- Questionnaire 47 and Turkish Health Literacy Scale-32 were found to be important predictors for awareness of the requirement for TRUS-Bx. CONCLUSION The study's findings indicate that patients with higher health literacy and education levels were more likely to receive an early diagnosis and promptly proceed with the recommended TRUS-Bx after visiting a urologist.
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Affiliation(s)
- Osman Gercek
- Department of Urology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
| | - Arif Demirbas
- Department of Urology, Istanbul Atlas University, Istanbul, Turkey
| | - Kutay Topal
- Department of Urology, Afyonkarahisar State Hospital, Afyonkarahisar, Turkey
| | - Berkay Eren
- Department of Urology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Veli Mert Yazar
- Department of Urology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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Jamieson SC, Mallory CW, Jivanji DR, Perez A, Castro G, Barengo NC, Pereira J, Nieder AM. THE ROLE OF HEALTH LITERACY IN PROSTATE CANCER SCREENING. Urology 2021; 163:112-118. [PMID: 34375651 DOI: 10.1016/j.urology.2021.05.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/17/2021] [Accepted: 05/02/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To determine if there is an association between self-reported health literacy and rates of prostate cancer screening through PSA testing. METHODS This secondary data analysis utilized information from the 2016 Behavioral Risk Factor Surveillance System (BRFSS). The primary exposure was self-reported health literacy, and the primary outcome was whether patients underwent prior PSA testing. Males 55-69 years old from 13 states were included in the study and were excluded if they had any missing data. Participants were categorized into low, moderate, or high level of health literacy. Confounders were adjusted for using binary logistic regression. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. RESULTS A total of 12,149 participants were included. Five percent of participants reported low health literacy, 54% moderate health literacy, and 41% high health literacy. Compared with study participants who self-reported high levels of health literacy, the odds of undergoing PSA testing were 59% lower in those with low health literacy (OR 0.41; 95% CI 0.28-0.64) and 30% lower in those with moderate health literacy (OR 0.70; 95% CI 0.60-0.83). CONCLUSIONS Our research demonstrates a positive association between self-reported health literacy and the likelihood of PSA screening. While PSA screening can be controversial, health literacy may serve as a window into which patients are more likely to be proactive in their urologic care. Future studies examining how health literacy effects other urologic conditions is necessary.
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Affiliation(s)
- Scott C Jamieson
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.
| | - Chase W Mallory
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Dhaval R Jivanji
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Alejandra Perez
- Columbia University Division of Urology, Mount Sinai Medical Center, Florida
| | - Grettel Castro
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Noël C Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA; Faculty of Medicine, Riga Stradins University, Riga, Latvia; Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
| | - Jorge Pereira
- Columbia University Division of Urology, Mount Sinai Medical Center, Florida
| | - Alan M Nieder
- Columbia University Division of Urology, Mount Sinai Medical Center, Florida
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Reis RBD, Alías-Melgar A, Martínez-Cornelio A, Neciosup SP, Sade JP, Santos M, Villoldo GM. Prostate Cancer in Latin America: Challenges and Recommendations. Cancer Control 2020; 27:1073274820915720. [PMID: 32316767 PMCID: PMC7177984 DOI: 10.1177/1073274820915720] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Prostate cancer (PCa) is the most frequent tumor among Latin American (LATAM)
men. The incidence of de novo metastatic PCa is higher in LATAM than other parts
of the world, and demographic changes in the region have increased disease
burden. However, region-specific information regarding prevalence, progression,
and treatment effectiveness is not currently available for nonmetastatic,
castration-resistant PCa (nmCRPC). Nonmetastatic, castration-resistant PCa is a
heterogeneous disease with varying potential to develop metastasis with limited
treatments available, until recently. New clinical trials with promising results
have allowed second-generation antiandrogen drugs to be used as first-line
treatments, rendering guidelines outdated. As a result, this panel of experts
reviewed the current status and challenges and developed recommendations for
nmCRPC diagnosis and management in LATAM. The Americas Health Foundation (AHF)
conducted a literature review and identified LATAM scientists and clinicians who
have published in the field of PCa since 2012. The AHF convened a panel of 7
chosen experts urologists and medical oncologists from the region. The AHF
developed specific questions relating to nmCRPC, which were answered by the
experts prior to the multiday meeting. Each narrative was discussed and edited
by the panel, through numerous rounds of discussion until a consensus was
reached in a final manuscript. The panel proposes specific and realistic
recommendations for improving access to diagnosis and management of PCa in
LATAM. No treatment has yet shown improvement in overall survival; however, when
including metastasis-free survival as an end point, second-generation
antiandrogen drugs have emerged as effective treatment options and are currently
included as first-line treatment. Although nmCRPC is a specific disease that
represents a small percentage of patients with PCa, effective diagnostic and
treatment strategies can contribute toward increasing quality of life and
survival rates of patients with PCa in LATAM.
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Affiliation(s)
- Rodolfo Borges Dos Reis
- Department of Urology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Alejandro Alías-Melgar
- Departamento de Urología, Centro Médico Nacional "20 de Noviembre", I.S.S.S.T.E. México, DF, México
| | - Andrés Martínez-Cornelio
- Servicio de Urología Oncológica, Hospital de Oncología, Centro Médico Nacional (CMN) Siglo XXI. México, DF, México
| | - Silvia P Neciosup
- Instituto Nacional de Enfermedades Neoplasicas, Surquillo, Lima, Peru
| | - Juan Pablo Sade
- Department of Genitourinary Tumors, Instituto Alexander Fleming, Buenos Aires, Argentina
| | - Marcos Santos
- UNESCO Chair of Bioethics, Faculty of Health and Sciences, University of Brasilia, Brasilia, Brazil
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Schwarzman LS, Abern MR, Garvey DF, Andriole GL, Freedland SJ, Moreira DM. The Association of Previous Prostate Biopsy Related Complications and the Type of Complication with Patient Compliance with Rebiopsy Scheme. J Urol 2018; 200:1062-1067. [PMID: 29906435 DOI: 10.1016/j.juro.2018.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2018] [Indexed: 10/14/2022]
Abstract
PURPOSE Prostate biopsy complications have important consequences that may affect patient compliance with rebiopsy schemes. However, to our knowledge this has not been studied in earnest. Thus, we evaluated whether previous prostate biopsy related complications and the type of complication were associated with repeat prostate biopsy compliance in a clinical trial with study mandated systematic biopsies. MATERIALS AND METHODS We retrospectively analyzed the records of 4,939 men 50 to 75 years old who underwent 2-year prostate biopsy and were recommended to undergo 4-year prostate rebiopsy in the REDUCE (Reduction by Dutasteride of Prostate Cancer Events) study. The analyzed biopsy complications were hematuria, urinary tract infection, acute urinary retention and hemospermia. RESULTS A total of 260 men (5.3%) had a 2-year prostate biopsy related complication, including hematuria in 180 (3.6%), urinary tract infection in 36 (0.7%), acute urinary retention in 26 (0.5%) and hemospermia in 102 (2.1%). A total of 474 men (9.6%) were noncompliant with 4-year rebiopsy. On univariable analysis any previous complication (OR 1.56, 95% CI 1.08-2.24, p = 0.018), urinary tract infection (OR 2.72, 95% CI 1.23-6.00, p = 0.013), acute urinary retention (OR 4.24, 95% CI 1.83-9.81, p = 0.016) and hemospermia (OR 1.78, 95% CI 1.03-3.06, p = 0.037) were associated with rebiopsy noncompliance. Hematuria was not associated with rebiopsy noncompliance (OR 1.19, 95% CI 0.74-1.91, p = 0.483). Results were unchanged on multivariable analysis, including for any complication (OR 1.65, 95% CI 1.08-2.26, p = 0.018), for urinary tract infection (OR 2.62, 95% CI 1.07-3.21, p = 0.029), for acute urinary retention (OR 4.51, 95% CI 1.93-10.54, p = 0.001), for hemospermia (OR 1.85, 95% CI 1.07-3.21, p = 0.029) and for hematuria (OR 1.19, 95% CI 0.74-1.93, p = 0.472). CONCLUSIONS In men who undergo repeat prostate biopsy a previous biopsy related complication and the type of complication were associated with lower compliance with rebiopsy schemes. Patients who experience biopsy related complications are ideal candidates to receive intervention regarding the importance of prostate rebiopsy to prevent noncompliance.
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Affiliation(s)
- Logan S Schwarzman
- Department of Urology, University of Illinois at Chicago, Chicago, Illinois
| | - Michael R Abern
- Department of Urology, University of Illinois at Chicago, Chicago, Illinois
| | - Daniel F Garvey
- Department of Urology, University of Illinois at Chicago, Chicago, Illinois
| | - Gerald L Andriole
- Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Stephen J Freedland
- Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California; Section of Urology, Durham Veterans Affairs Medical Center, Durham, North Carolina
| | - Daniel M Moreira
- Department of Urology, University of Illinois at Chicago, Chicago, Illinois.
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Tourinho-Barbosa RR, Pompeo ACL, Glina S. Prostate cancer in Brazil and Latin America: epidemiology and screening. Int Braz J Urol 2016; 42:1081-1090. [PMID: 27622278 PMCID: PMC5117963 DOI: 10.1590/s1677-5538.ibju.2015.0690] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 05/15/2016] [Accepted: 05/15/2016] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Prostate cancer is one of the tumors with higher incidence and mortality among men in the World. Epidemiological data are influenced by life expectancy of population, available diagnostic methods, correct collection of data and quality of health services. Screening of the disease is not standardized around the World. Up till now there is no consensus about the risks versus benefits of early detection. There are still missing data about this pathology in Latin America. OBJECTIVE to revise current epidemiologic situation and early diagnosis policies of prostate cancer in Brazil and Latin America. MATERIALS AND METHODS Medline, Cochrane Library and SciELO databases were reviewed on the subject of epidemiology and screening of prostate cancer. Screening research was performed in websites on national public health organizations and Latin America. Screening recommendations were obtained from those governmental organizations and from Latin American urological societies and compared to the most prominent regulatory agencies and societies of specialists and generalists from around the World. RESULTS Brazil and Latin America have a special position in relation to incidence and mortality of prostate cancer. In Brazil, it occupies the first position regarding incidence of cancer in men and the second cause of mortality. Central America has the highest rate of mortality of the continent with lower incidence/mortality ratios. Screening recommendations are very distinct, mainly among regulatory organs and urological societies. CONCLUSION prostate cancer epidemiology is an important health public topic. Data collection related to incidence and mortality is still precarious, especially in less developed countries. It is necessary to follow-up long term screening studies results in order to conclude its benefits.
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Affiliation(s)
| | | | - Sidney Glina
- Departamento Urologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil
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Guessous I, Cullati S, Fedewa SA, Burton-Jeangros C, Courvoisier DS, Manor O, Bouchardy C. Prostate cancer screening in Switzerland: 20-year trends and socioeconomic disparities. Prev Med 2016; 82:83-91. [PMID: 26582208 DOI: 10.1016/j.ypmed.2015.11.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 11/03/2015] [Accepted: 11/05/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND Despite important controversy in its efficacy, prostate cancer (PCa) screening has become widespread. Important socioeconomic screening disparities have been reported. However, trends in PCa screening and social disparities have not been investigated in Switzerland, a high risk country for PCa. We used data from five waves (from 1992-2012) of the population-based Swiss Health Interview Survey to evaluate trends in PCa screening and its association with socioeconomic indicators. METHODS We used multivariable Poisson regression to estimate prevalence ratios (PR) and 95% Confidence Intervals (CI) adjusting for demographics, health status, and use of healthcare. RESULTS The study included 12,034 men aged ≥50 years (mean age: 63.9). Between 1992 and 2012, ever use of PCa screening increased from 55.3% to 70.0% and its use within the last two years from 32.6% to 42.4% (p-value <0.05). Income, education, and occupational class were independently associated with PCa screening. PCa screening within the last two years was greater in men with the highest (>$6,000/month) vs. lowest income (≤$2,000) (46.5% vs. 38.7% in 2012, PR for overall period =1.29, 95%CI: 1.13-1.48). These socioeconomic disparities did not significantly change over time. CONCLUSIONS This study shows that about half of Swiss men had performed at least one PCa screening. Men belonging to high socioeconomic status are clearly more frequently screened than those less favored. Given the uncertainty of the usefulness of PCa screening, men, including those with high socioeconomic status, should be clearly informed about benefits and harms of PCa screening, in particular, the adverse effect of over-diagnosis and of associated over-treatment.
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Affiliation(s)
- Idris Guessous
- Unit of population epidemiology, Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva, Geneva, Switzerland; Emory University, Department of Epidemiology, Atlanta, GA, USA; Division of chronic diseases, Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland.
| | - Stéphane Cullati
- Unit of population epidemiology, Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | - Stacey A Fedewa
- Emory University, Department of Epidemiology, Atlanta, GA, USA; American Cancer Society, Atlanta, GA, USA
| | | | | | - Orly Manor
- School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel
| | - Christine Bouchardy
- Geneva Cancer Registry, Global Health Institute, University of Geneva, Geneva, Switzerland
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Moses KA, Master VA, Underwood W. Race, Ethnicity, Marital Status, Literacy, and Prostate Cancer Outcomes in the United States. Prostate Cancer 2016. [DOI: 10.1016/b978-0-12-800077-9.00016-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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