Health disparities in clinical practice patterns for prostate cancer screening by geographic regions in the United States: a multilevel modeling analysis

Garg, Vishvas; Raisch, Dennis W.; Selig, James P.; Thompson, Terri-Ann

doi:10.1038/pcan.2013.3

Cited by 13 publications

(16 citation statements)

References 29 publications

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“…Around half (18) of the included studies were from the United States (USA), followed by Australia (19), the United Kingdom (UK, 24), Canada (5), Spain (4), the Netherlands (3), New Zealand (3), Denmark (2), France (2), and Ireland (2). Seven more studies were also from Europe (one each from Belgium, Finland, Germany, Greece, Lithuania, Sweden, and Switzerland), five from Asia (two from Japan, one each from Iran, South Korea and Taiwan), two from other parts of North America (French West Indies, Puerto Rico), one from South America (Colombia), one from Africa (Egypt) and one including Australia and Canada (Supplemental File 3).…”

Section: Resultsmentioning

confidence: 99%

Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence

et al. 2019

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Background: Previous reviews of geographical disparities in the prostate cancer continuum from diagnosis to mortality have identified a consistent pattern of poorer outcomes with increasing residential disadvantage and for rural residents. However, there are no contemporary, systematic reviews summarizing the latest available evidence. Our objective was to systematically review the published international evidence for geographical variations in prostate cancer indicators by residential rurality and disadvantage. Methods: Systematic searches of peer-reviewed articles in English published from 1/1/1998 to 30/06/2018 using PubMed, EMBASE, CINAHL, and Informit databases. Inclusion criteria were: population was adult prostate cancer patients; outcome measure was PSA testing, prostate cancer incidence, stage at diagnosis, access to and use of services, survival, and prostate cancer mortality with quantitative results by residential rurality and/or disadvantage. Studies were critically appraised using a modified Newcastle-Ottawa Scale. Results: Overall 169 studies met the inclusion criteria. Around 50% were assessed as high quality and 50% moderate. Men from disadvantaged areas had consistently lower prostate-specific antigen (PSA) testing and prostate cancer incidence, poorer survival, more advanced disease and a trend toward higher mortality. Although less consistent, predominant patterns by rurality were lower PSA testing, prostate cancer incidence and survival, but higher stage disease and mortality among rural men. Both geographical measures were associated with variations in access and use of prostate cancer-related services for low to high risk disease. Conclusions: This review found substantial evidence that prostate cancer indicators varied by residential location across diverse populations and geographies. While wide variations in study design limited comparisons across studies, our review indicated that internationally, men living in disadvantaged areas, and to a lesser extent more rural areas, face a greater prostate cancer burden. This review highlights the need for a better understanding of the complex social, environmental, and behavioral reasons for these variations, recognizing that, while important, geographical access is not the only issue. Implementing research strategies to help identify these processes and to better understand the central role of disadvantage to variations in health outcome are crucial to inform the development of evidence-based targeted interventions.

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Section: Resultsmentioning

confidence: 99%

Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence

et al. 2019

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“…The geographical and prostate cancer factors found in selected disparity studies have been summarized in the Table. [12][13][14][15][16][17][18][19][20][21][22][23][24][25]…”

Section: Resultsmentioning

confidence: 99%

“…52 In the field of prostate cancer, research using GIS approaches has been conducted to investigate diagnoses, management, and treatment outcomes across different geographical levels, such as counties, census division/tracts, cancer registry areas, and other aggregate geographical scales. [12][13][14][15][16][17][18][19][20][21][22][23][24][25][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68] Cockburn et al 53 used the GIS to geocode the historical residential addresses of individuals and measured the association between ambient exposure to pesticide and incidence rates of prostate cancer in California. They found a positive relationship between prostate cancer and ambient pesticide exposure in and around homes in intensely agricultural areas.…”

Section: Geographical Information System and Its Role In Disparity Rementioning

confidence: 99%

Geographical Factors Associated with Health Disparities in Prostate Cancer

2016

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Disparities in prostate cancer are common and persistent, and notable differences in treatment are observable across racial and socioeconomic strata. Geographical analysis provides additional information about where disparate groups live and also helps to map access to care. This information can be used by public health officials, health-systems administrators, clinicians, and policymakers to better understand and respond to geographical barriers that contribute to disparities in care.

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“…A smaller study (94 cases, 167 controls), which did not adjust for education level, found that circumcision conferred an increased risk of prostate cancer (OR 1.89, 95% CI 1.13–3.18) . This finding may have been attributable to a higher education level amongst cases, which is associated with a greater tendency to be circumcised and to undergo screening for prostate cancer by, either PSA screening and/or DRE .…”

Section: Discussionmentioning

confidence: 95%

“…In addition, men in the present study who were circumcised late in life had a lower education level than those circumcised earlier. Education is positively associated with being screened, and thus diagnosed for prostate cancer . However, as the protective effect of circumcision at a late age persisted after adjustment for education and diabetes, other factors appear to be at play.…”

Section: Discussionmentioning

confidence: 96%

Circumcision and prostate cancer: a population‐based case‐control study in Montréal, Canada

et al. 2014

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ObjectivesTo investigate the possible association between circumcision and prostate cancer risk, to examine whether age at circumcision influences prostate cancer risk, and to determine whether race modifies the circumcision–prostate cancer relationship.Subjects and MethodsPROtEuS (Prostate Cancer and Environment Study), a population-based case-control study set amongst the mainly French-speaking population in Montréal, Canada, was used to address study objectives. The study included 1590 pathologically confirmed prostate cancer cases diagnosed in a Montréal French hospital between 2005 and 2009, and 1618 population controls ascertained from the French electoral list, frequency-matched to cases by age. In-person interviews elicited information on sociodemographic, lifestyle and environmental factors. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) between circumcision, age at circumcision and prostate cancer risk, adjusting for age, ancestry, family history of prostate cancer, prostate cancer screening history, education, and history of sexually transmitted infections.ResultsCircumcised men had a slightly lower risk, albeit not statistically significant, of developing prostate cancer than uncircumcised men (OR 0.89, 95% CI 0.76–1.04). Circumcision was found to be protective in men circumcised aged ≥36 years (OR 0.55, 95% CI 0.30–0.98). A weaker protective effect was seen among men circumcised within 1 year of birth (OR 0.86, 95% CI 0.72–1.04). The strongest protective effect of circumcision was recorded in Black men (OR 0.40, 95% CI 0.19–0.86, P-value for interaction 0.02) but no association was found with other ancestral groups.ConclusionOur findings provide novel evidence for a protective effect of circumcision against prostate cancer development, especially in those circumcised aged ≥36 years; although circumcision before the age of 1 year may also confer protection. Circumcision appeared to be protective only among Black men, a group that has the highest rate of disease. Further research into the differences in effect of circumcision on prostate cancer risk by ancestry is warranted, as is the influence of age at circumcision.

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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

Abstract: Men living in urban areas and states with lower prevalence of doctors have lower odds of screening for prostate cancer and PSAT, respectively, after adjusting for individual variables. Future studies should examine the reasons for these health disparities.

Cited by 13 publications

References 29 publications

Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence

Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence

Geographical Factors Associated with Health Disparities in Prostate Cancer

Circumcision and prostate cancer: a population‐based case‐control study in Montréal, Canada

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