Prostate cancer screening patterns changed between 2002 and 2006 for black men over age 40 versus white men in the same age range. This indicates that physicians are becoming more aware of the higher risk for prostate cancer at a younger age among black men, and are increasing their screening in this group, a new study suggests. The study, involving 229,574 men in this age group without prostate cancer provides a 4-year snapshot of the use of the prostate-specific antigen (PSA) assay and digital rectal examination (DRE) in screening for the disease.
After adjusting for other demographic and health factors, black men had higher odds of having had a recent PSA test alone or both a PSA and a DRE test than did white men (67 percent vs. 61 percent higher, respectively). Hispanic men were more likely than white men to have had a recent PSA test, but less likely to have had a recent DRE test (61 percent higher and 22 percent lower, respectively). The use of both tests combined did not differ significantly between these two populations.
Most men (who were surveyed in 2002, 2004, and 2006) reported having both a PSA and DRE test in the past 2 years for each year surveyed. Factors associated with use of both tests included older age, being married or widowed, being employed, having higher levels of education and income, having health insurance, and having a personal health care provider or a usual source of care. The data were collected through the Behavioral Risk Factor Surveillance System, established by the Centers for Disease Control and Prevention, one of the largest State-based telephone health surveys ever implemented.
The researchers recommend that further research be undertaken to see whether these patterns of screening test use, especially among black men, continue to change over time. The study was funded in part by the Agency for Healthcare Research and Quality (HS13353).
More details are in "Patterns in prostate-specific antigen test use and digital rectal examinations in the Behavioral Risk Factor Surveillance System, 2002-2006," by Louie E. Ross, Ph.D., Yhenneko J. Taylor, M.S., Lisa C. Richardson, M.D., M.P.H., and others in the April 2009 Journal of the National Medical Association 101(4), pp. 316-324.
For a more detailed analysis of the black men in the study, see "Prostate-specific antigen test use and digital rectal examinations among African-American men, 2002-2006," by Dr. Ross, Shelly-Ann Meade, M.S., Barbara D. Powe, Ph.D, R.N., and others in the July 2009 Journal of the National Black Nurses Association 20(1), pp. 52-58.