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Patient and Physician Factors Associated with Undisclosed Prostate Cancer Screening in a Sample of Predominantly Immigrant Black Men

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Abstract

Medical guidelines do not recommend prostate cancer screening, particularly without informed and shared decision making. This study investigates undisclosed opportunistic screening using prostate specific antigen (PSA) testing in black immigrant and African American men. Participants (N = 142) were insured urban men, 45- to 70-years old. Patients’ reports of testing were compared with medical claims to assess undisclosed PSA testing. Most (94.4 %) men preferred to share in screening decisions, but few (46.5 %) were aware PSA testing was performed. Four factors predicted being unaware of testing: low formal education, low knowledge about prostate cancer, no intention to screen, and no physician recommendation (all p’s < .05). Undisclosed PSA testing was common. Both patient and provider factors increased risk of being uninformed about prostate cancer screening. Interventions combining patient education and physician engagement in shared decision making may better align practice with current prostate cancer screening guidelines.

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References

  1. Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin. 2014;64:9–29.

    Article  PubMed  Google Scholar 

  2. Odedina FT, Akinremi TO, Chinegwundoh F, Roberts R, Yu D, Reams RR, Freedman ML, Rivers B, Lee Green B, Kumar N. Prostate cancer disparities in Black men of African descent: a comparative literature review of prostate cancer burden among black men in the United States, Caribbean, United Kingdom, and West Africa. Infect Agent Cancer. 2009;4(Suppl I):52.

    Google Scholar 

  3. Mariotto AB, Etzioni R, Krapcho M, Feuer EJ. Reconstructing PSA testing patterns between black and white men in the US from Medicare claims and the National Health Interview Survey. Cancer. 2007;109:1877–86.

    Article  PubMed  Google Scholar 

  4. Ross L, Taylor Y. Patterns in prostate-specific antigen test use and digital rectal examinations in the Behavioral Risk Factor Surveillance System, 2002–2006. J Natl Cancer Inst. 2009;101:316.

    Google Scholar 

  5. Hoffman RM. Screening for prostate cancer. N Engl J Med. 2011;365:2013–9.

    Article  CAS  PubMed  Google Scholar 

  6. Godtman RA, Holmberg E, Lilja H, Stranne J, Hugosson J. Opportunistic testing versus organized prostate-specific antigen screening: outcome after 18 years in the Göteborg randomized population-based prostate cancer screening trial. Eur Urol. 2015;68:354–60.

    Article  Google Scholar 

  7. Nordström T, Aly M, Clements MS, Weibull CE, Adolfsson J, Grönberg H. Prostate-specific antigen (PSA) testing is prevalent and increasing in Stockholm county, Sweden, despite no recommendations for PSA screening: results from a population-based study, 2003–2011. Eur Urol. 2013;63:419–25.

    Article  PubMed  Google Scholar 

  8. D’Ambrosio GG, Campo S, Cancian M, Pecchioli S, Mazzaglia G. Opportunistic prostate-specific antigen screening in Italy: 6 years of monitoring from the Italian general practice database. Eur J Cancer Prev. 2010;19:413–6.

    Article  PubMed  Google Scholar 

  9. Andriole GL, Crawford ED, Grubb RL, Buys SS, Chia D, Church TR, Fouad MN, Gelman EP, Kvale PA, Reding DJ, Weissfeld JL, Yokochi LA, O’Brien B, Clapp JD, Rathmell JM, Riley TL, Hayes RB, Kramer BS, Izmirlian G, Miller AB, Pinsky PF, Prorok PC, Gohagan JK, Berg CD. Mortality results from a randomized prostate-cancer screening trial. N Engl J Med. 2009;360:1310–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Han PKJ, Kobrin S, Breen N, Joseph DA, Li J, Frosch DL, Klabunde CN. National evidence on the use of shared decision making in prostate-specific antigen screening. Ann Fam Med. 2013;11:306–14.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Consedine NS, Tuck NL, Ragin CR, Spencer BA. Beyond the black box: a systematic review of breast, prostate, colorectal, and cervical screening among native and immigrant African-descent Caribbean populations. J Immigr Minor Health. 2015;17:905–24.

    Article  PubMed  Google Scholar 

  12. Chou R, Croswell JM, Dana T, Bougatsos C, Blazina I, Fu R, Gleitsmann K, Koenig HC, Lam C, Maltz A, Rugge B, Lin K. Screening for prostate cancer: a review of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2011;155:762–71.

    Article  PubMed  Google Scholar 

  13. Drazer MW, Prasad SM, Huo D, Schonberg MA, Dale W, Szmulewitz RZ, Eggener SE. National trends in prostate cancer screening among older American men with limited 9-year life expectancies: evidence of an increased need for shared decision making. Cancer. 2014;120:1491–8.

    Article  PubMed  Google Scholar 

  14. Moyer VA. Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012;157:120–34.

    Article  PubMed  Google Scholar 

  15. Carter HB, Albertsen PC, Barry MJ, Etzioni R, Freedland SJ, Greene KL, Holmberg L, Kantoff P, Konety BR, Murad MH, Penson DF, Zietman AL. Early detection of prostate cancer: AUA guideline. J Urol. 2013;190:419–26.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Qaseem A, Barry M. Screening for prostate cancer: a guidance statement from the Clinical Guidelines Committee of the American College of Physicians. Ann Intern Med. 2013;158:761–9.

    Article  PubMed  Google Scholar 

  17. Basch E, Oliver TK, Vickers A, Thompson I, Kantoff P, Parnes H, Loblaw DA, Roth B, Williams J, Nam RK. Screening for prostate cancer with prostate-specific antigen testing: American Society of Clinical Oncology provisional clinical opinion. J Clin Oncol. 2012;30:3020–5.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Smith RA, Manassaram-Baptiste D, Brooks D, Cokkinides V, Doroshenk M, Saslow D, Wender RC, Brawley OW. Cancer screening in the United States, 2014. CA Cancer J Clin. 2014;64:30–51.

    Article  PubMed  Google Scholar 

  19. Smith RA, von Eschenbach AC, Wender R, Levin B, Byers T, Rothenberger D, Brooks D, Creasman W, Cohen C, Runowicz C, Saslow D, Cokkinides V, Eyre H. American Cancer Society guidelines for the early detection of cancer: update of early detection guidelines for prostate, colorectal, and endometrial cancers: Also: update 2001—testing for early lung cancer detection. CA Cancer J Clin. 2001;51:38–75.

    Article  CAS  PubMed  Google Scholar 

  20. Oberg A, Allan JD, Frame P, Homer CJ. Screening for prostate cancer: recommendation and rationale. Ann Intern Med. 2002;137:915.

    Article  Google Scholar 

  21. American Urological Association (AUA). Prostate-specific antigen (PSA) best practice policy. Oncology. 2000;14:267–86.

    Google Scholar 

  22. American College of Physicians. Screening for prostate cancer. Ann Intern Med. 1997;126:480–4.

    Article  Google Scholar 

  23. O’Connor AM, Llewellyn-Thomas HA, Flood AB. Modifying unwarranted variations in health care: shared decision making using patient decision aids. Health Aff. 2004;23:VAR63–72.

    Google Scholar 

  24. Volk RJ, Hawley ST, Kneuper S, Holden EW, Stroud LA, Cooper CP, Berkowitz JM, Scholl LE, Saraykar SS, Pavlik VN. Trials of decision aids for prostate cancer screening: a systematic review. Am J Prev Med. 2007;33:428–34.

    Article  PubMed  Google Scholar 

  25. Hoffman RM, Elmore JG, Fairfield KM, Gerstein BS, Levin CA, Pignone MP. Lack of shared decision making in cancer screening discussions: results from a national survey. Am J Prev Med. 2014;47:251–9.

    Article  PubMed  Google Scholar 

  26. Guerra CE, Jacobs SE, Holmes JH, Shea JE. Are physicians discussing prostate cancer screening with their patients and why or why not? A pilot study. J Gen Intern Med. 2007;22:901–7.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Kripalani A, Sharma S, Justice J, Justice E, Spiker J, Laufman C, Jacobson LE, Weinberg TA. Prostate cancer screening in a low-literacy population: does informed decision making occur? Cancer Control. 2005;12:116–7.

    Article  PubMed  Google Scholar 

  28. Arnsrud Godtman R, Holmberg E, Lilja H, Stranne J, Hugosson J. Opportunistic testing versus organized prostate-specific antigen screening: outcome after 18 years in the Göteborg randomized population-based prostate cancer screening trial. Eur Urol. 2014;68:354–360.

    Article  PubMed  Google Scholar 

  29. Chan ECY, Vernon SW, Ahn C, Greisinger A. Do men know that they have had a prostate-specific antigen test? Accuracy of self-reports of testing at 2 sites. Am J Public Health. 2004;94:1336–8.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Gattellari M, Ward JE. Men’s reactions to disclosed and undisclosed opportunistic PSA screening for prostate cancer. Med J Aust. 2005;182:386–9.

    PubMed  Google Scholar 

  31. Lepore SJ, Wolf RL, Basch CE, Godfrey M, McGinty E, Shmukler C, Ullman R, Thomas N, Weinrich S. Informed decision making about prostate cancer testing in predominantly immigrant black men: a randomized controlled trial. Ann Behav Med. 2012;44:320–30.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Sangha O, Stucki G, Liang MH, Fossel AH, Katz JN. The Self-Administered Comorbidity Questionnaire: a new method to assess comorbidity for clinical and health services research. Arthritis Rheum. 2003;49:156–63.

    Article  PubMed  Google Scholar 

  33. Barry MJ, Fowler FJ, O’Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, Cockett AT. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol. 1992;148:1549–57.

    Article  CAS  PubMed  Google Scholar 

  34. Degner LF, Sloan JA, Venkatesh P. The Control Preferences Scale. Can J Nurs Res. 1997;29:21–43.

    CAS  PubMed  Google Scholar 

  35. Williams RM, Zincke NL, Turner RO, Davis JL, Davis KM, Schwartz MD, Johnson L, Kerner JF, Taylor KL. Prostate cancer screening and shared decision-making preferences among African-American members of the Prince Hall Masons. Psychooncology. 2008;17:1006–13.

    Article  PubMed  Google Scholar 

  36. Davison BJ, Kirk P, Degner LF, Hassard TH. Information and patient participation in screening for prostate cancer. Patient Educ Couns. 1999;37:255–63.

    Article  CAS  PubMed  Google Scholar 

  37. Volk KJ, Cass RJ, Spann AR. Screening for prostate cancer with the prostate-specific antigen test. Are patients making informed decisions? J Fam Pract. 1999;48:682–8.

    PubMed  Google Scholar 

  38. Winterich JA, Grzywacz JG, Quandt SA, Clark PE, Miller DP, Acuna J, Dignan MB, Arcury TA. Men’s knowledge and beliefs about prostate cancer: education, race and screening status. Ethn Dis. 2009;19:199–203.

    PubMed  PubMed Central  Google Scholar 

  39. Dunn AS, Shridharani KV, Lou W, Bernstein J, Horowitz CR. Physician-patient discussions of controversial cancer screening tests. Am J Prev Med. 2001;20:130–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Volk RJ, Jibaja-Weiss ML, Hawley ST, Kneuper S, Spann SJ, Miles BJ, Hyman DJ. Entertainment education for prostate cancer screening: a randomized trial among primary care patients with low health literacy. Patient Educ Couns. 2008;73:482–9.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Diefenbach M. To screen or not to screen…: a comment on Lepore et al. Ann Behav Med. 2012;44:299–300.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Stiggelbout AM, Pieterse AH, De Haes JCJM. Shared decision making: concepts, evidence, and practice. Patient Educ Couns. 2015;98:1172–9.

    Article  CAS  PubMed  Google Scholar 

  43. Taylor KL, Davis JL, Turner RO, Johnson L, Schwartz MD, Kerner JF, Leak C. Educating African American men about the prostate cancer screening dilemma: a randomized intervention. Cancer Epidemiol Biomark Prev. 2006;15:2179–88.

    Article  Google Scholar 

  44. Chan ECY, McFall SL, Byrd TL, Mullen PD, Volk RJ, Ureda J, Calderon-Mora J, Morales P, Valdes A, Kay Bartholomew L. A community-based intervention to promote informed decision making for prostate cancer screening among Hispanic American men changed knowledge and role preferences: a cluster RCT. Patient Educ Couns. 2011;84:e44–51.

    Article  PubMed  Google Scholar 

  45. Williams RM, Davis KM, Luta G, Edmond SN, Dorfman CS, Schwartz MD, Lynch J, Anaghotu C, Taylor KL. Fostering informed decisions: a randomized controlled trial assessing the impact of a decision aid among men registered to undergo mass screening for prostate cancer. Patient Educ Couns. 2013;91:329–36.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Shanafelt TD, Dyrbye LN, Sinsky C, Hasan O, Satele D, Sloan J, West CP. Relationship between clerical burden and characteristics of the electronic environment with physician burnout and professional satisfaction. Mayo Clin Proc. 2016;91:836–48.

    Article  PubMed  Google Scholar 

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Acknowledgments

This research was supported by Grant R01 CA104223 from the National Cancer Institute of the National Institutes of Health. The study sponsor had no role in study design; collection, analysis, and interpretation of data; report writing; and the decision to submit the report for publication.

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Authors and Affiliations

  1. Department of Social and Behavioral Sciences, College of Public Health, Temple University, 957 Ritter Annex, 1301 Cecil B. Moore Ave, Philadelphia, PA, 19122, USA

    Stephen J. Lepore

  2. Department of Biostatistics and Epidemiology, College of Public Health, Temple University, 1301 Cecil B. Moore Ave, Philadelphia, PA, 19122, USA

    Rasmi G. Nair

  3. Department of Health Outcomes and Behaviors, Moffitt Cancer Center, Tampa, FL, 33612, USA

    Stacy N. Davis

  4. Department of Health and Behavioral Studies, Teachers College, Columbia University, 525 West 120th Street, New York, NY, 10027, USA

    Randi L. Wolf & Charles E. Basch

  5. 1199SEIU Benefit and Pension Funds, 330 W. 42nd Street, New York, NY, 10036, USA

    Nigel Thomas, Celia Shmukler & Ralph Ullman

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  1. Stephen J. Lepore
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Correspondence to Stephen J. Lepore.

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Ethical Approval

All procedures involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Research Involving Human Participants and/or Animals

This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Lepore, S.J., Nair, R.G., Davis, S.N. et al. Patient and Physician Factors Associated with Undisclosed Prostate Cancer Screening in a Sample of Predominantly Immigrant Black Men. J Immigrant Minority Health 19, 1343–1350 (2017). https://doi.org/10.1007/s10903-016-0468-1

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  • DOI: https://doi.org/10.1007/s10903-016-0468-1

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