Racial Disparities in Prostate Specific Antigen Screening and Referral to Urology in a Large, Integrated Health Care System: A Retrospective Cohort Study
2021; Lippincott Williams & Wilkins; Volume: 206; Issue: 2 Linguagem: Inglês
10.1097/ju.0000000000001763
ISSN1527-3792
AutoresCaroline Lu, Oluwaseun Adeyemi, William E. Anderson, Timothy Hetherington, David C. Slawson, Hazel Tapp, Tara Eaton, Earle F. Burgess, Claud Grigg, Jason Zhu, Kris E. Gaston, Stephen B. Riggs, Peter E. Clark, Yhenneko J. Taylor, James T. Kearns,
Tópico(s)Healthcare Policy and Management
ResumoNo AccessJournal of UrologyAdult Urology1 Aug 2021Racial Disparities in Prostate Specific Antigen Screening and Referral to Urology in a Large, Integrated Health Care System: A Retrospective Cohort Study Caroline D. Lu, Oluwaseun Adeyemi, William E. Anderson, Timothy C. Hetherington, David C. Slawson, Hazel Tapp, Tara A. Eaton, Earle F. Burgess, Claud M. Grigg, Jason Z. Zhu, Kris E. Gaston, Stephen B. Riggs, Peter E. Clark, Yhenneko J. Taylor, and James T. Kearns Caroline D. LuCaroline D. Lu Atrium Health, Carolinas Medical Center, Department of Urology, Charlotte, North Carolina , Oluwaseun AdeyemiOluwaseun Adeyemi Atrium Health, Center for Outcomes Research and Evaluation, Charlotte, North Carolina , William E. AndersonWilliam E. Anderson Atrium Health, Center for Outcomes Research and Evaluation, Charlotte, North Carolina , Timothy C. HetheringtonTimothy C. Hetherington Atrium Health, Center for Outcomes Research and Evaluation, Charlotte, North Carolina , David C. SlawsonDavid C. Slawson http://orcid.org/0000-0002-6374-5718 Atrium Health, Carolinas Medical Center, Elizabeth Family Medicine, Charlotte, North Carolina, Atrium Health, Carolinas Medical Center, Department of Family Medicine, Charlotte, North Carolina , Hazel TappHazel Tapp http://orcid.org/0000-0003-0867-4635 Atrium Health, Carolinas Medical Center, Department of Family Medicine, Charlotte, North Carolina , Tara A. EatonTara A. Eaton http://orcid.org/0000-0002-3975-0947 Atrium Health, Center for Outcomes Research and Evaluation, Charlotte, North Carolina , Earle F. BurgessEarle F. Burgess http://orcid.org/0000-0003-4293-4680 Levine Cancer Institute, Charlotte, North Carolina , Claud M. GriggClaud M. Grigg http://orcid.org/0000-0001-8847-5366 Levine Cancer Institute, Charlotte, North Carolina , Jason Z. ZhuJason Z. Zhu http://orcid.org/0000-0003-0328-665X Levine Cancer Institute, Charlotte, North Carolina , Kris E. GastonKris E. Gaston Atrium Health, Carolinas Medical Center, Department of Urology, Charlotte, North Carolina Levine Cancer Institute, Charlotte, North Carolina , Stephen B. RiggsStephen B. Riggs Atrium Health, Carolinas Medical Center, Department of Urology, Charlotte, North Carolina Levine Cancer Institute, Charlotte, North Carolina , Peter E. ClarkPeter E. Clark Atrium Health, Carolinas Medical Center, Department of Urology, Charlotte, North Carolina Levine Cancer Institute, Charlotte, North Carolina , Yhenneko J. TaylorYhenneko J. Taylor http://orcid.org/0000-0002-5336-5666 Atrium Health, Center for Outcomes Research and Evaluation, Charlotte, North Carolina , and James T. KearnsJames T. Kearns *Correspondence: Levine Cancer Institute, 1021 Morehead Medical Drive, Building One, Suite 5300, Charlotte, North Carolina 28204 telephone: 980-442-7010; FAX: 980-442-5031; E-mail Address: [email protected] http://orcid.org/0000-0002-5416-4671 Atrium Health, Carolinas Medical Center, Department of Urology, Charlotte, North Carolina Atrium Health, Center for Outcomes Research and Evaluation, Charlotte, North Carolina Levine Cancer Institute, Charlotte, North Carolina View All Author Informationhttps://doi.org/10.1097/JU.0000000000001763AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Contemporary trends and racial disparities in prostate cancer screening and referral to urology for prostate cancer risk are not well characterized, despite consensus that Black men are at higher risk for poor prostate cancer outcomes. The objective of this study was to characterize current racial disparities in prostate cancer screening and referral from primary care to urology for prostate cancer concern within our large, integrated health care system. Materials and Methods: This retrospective cohort study used data from Atrium Health's enterprise data warehouse, which includes patient information from more than 900 care locations across North Carolina, South Carolina and Georgia. We included all men seen in the ambulatory or outpatient setting between 2014 and 2019 who were ≥40 years old. Clinical and demographic data were collected for all men, including age and race. Racial outcomes were reported for all groups with >2% representation in the population. Between-group comparisons were determined using chi-squared analysis, Wilcoxon rank sum testing and multivariable logistic regression, with significance defined as p <0.05. Results: We observed a significant decrease in prostate specific antigen testing across all age and racial groups in a cohort of 606,985 men at Atrium Health, including 87,189 Black men, with an overall relative decline of 56%. As compared to White men, Black men were more likely to undergo prostate specific antigen testing (adjusted OR 1.24, 95% CI 1.22–1.26) and be referred to urology for prostate cancer (adjusted OR 1.94, 95% CI 1.75–2.16). Conclusions: There was a continued significant decline in prostate cancer screening between 2014 and 2019. Despite having modestly elevated odds of being screened for prostate cancer compared to White men, Black men are relatively underscreened when considering that those who undergo prostate specific antigen screening are more likely to be referred by primary care to urology for additional prostate cancer diagnostic evaluation. References 1. : Cancer statistics, 2017. CA Cancer J Clin 2017; 67: 7. 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Available at https://linc.osbm.nc.gov/pages/population-housing/. Accessed April 30, 2020. Google Scholar © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue 2August 2021Page: 270-278 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.Keywordsearly detection of cancerprostatic neoplasmsprostate-specific antigenhealth services researchMetricsAuthor Information Caroline D. Lu Atrium Health, Carolinas Medical Center, Department of Urology, Charlotte, North Carolina More articles by this author Oluwaseun Adeyemi Atrium Health, Center for Outcomes Research and Evaluation, Charlotte, North Carolina More articles by this author William E. Anderson Atrium Health, Center for Outcomes Research and Evaluation, Charlotte, North Carolina More articles by this author Timothy C. Hetherington Atrium Health, Center for Outcomes Research and Evaluation, Charlotte, North Carolina More articles by this author David C. Slawson Atrium Health, Carolinas Medical Center, Elizabeth Family Medicine, Charlotte, North Carolina, Atrium Health, Carolinas Medical Center, Department of Family Medicine, Charlotte, North Carolina More articles by this author Hazel Tapp Atrium Health, Carolinas Medical Center, Department of Family Medicine, Charlotte, North Carolina More articles by this author Tara A. Eaton Atrium Health, Center for Outcomes Research and Evaluation, Charlotte, North Carolina More articles by this author Earle F. Burgess Levine Cancer Institute, Charlotte, North Carolina More articles by this author Claud M. Grigg Levine Cancer Institute, Charlotte, North Carolina More articles by this author Jason Z. Zhu Levine Cancer Institute, Charlotte, North Carolina More articles by this author Kris E. Gaston Atrium Health, Carolinas Medical Center, Department of Urology, Charlotte, North Carolina Levine Cancer Institute, Charlotte, North Carolina More articles by this author Stephen B. Riggs Atrium Health, Carolinas Medical Center, Department of Urology, Charlotte, North Carolina Levine Cancer Institute, Charlotte, North Carolina More articles by this author Peter E. Clark Atrium Health, Carolinas Medical Center, Department of Urology, Charlotte, North Carolina Levine Cancer Institute, Charlotte, North Carolina More articles by this author Yhenneko J. Taylor Atrium Health, Center for Outcomes Research and Evaluation, Charlotte, North Carolina More articles by this author James T. Kearns Atrium Health, Carolinas Medical Center, Department of Urology, Charlotte, North Carolina Atrium Health, Center for Outcomes Research and Evaluation, Charlotte, North Carolina Levine Cancer Institute, Charlotte, North Carolina *Correspondence: Levine Cancer Institute, 1021 Morehead Medical Drive, Building One, Suite 5300, Charlotte, North Carolina 28204 telephone: 980-442-7010; FAX: 980-442-5031; E-mail Address: [email protected] Financial interest and/or other relationship with Angiodynamics. More articles by this author Expand All Advertisement Loading ...
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