PD40-05 CONTEMPORARY RACIAL DISPARITIES IN PSA SCREENING AND PROSTATE CANCER DIAGNOSIS IN A LARGE, INTEGRATED HEALTHCARE SYSTEM

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life and Shared Decision Making IV (PD40)1 Apr 2020PD40-05 CONTEMPORARY RACIAL DISPARITIES IN PSA SCREENING AND PROSTATE CANCER DIAGNOSIS IN A LARGE, INTEGRATED HEALTHCARE SYSTEM Caroline D Lu*, Oluwaseun Adeyemi, William E Anderson, Timothy C Hetherington, Yhenneko J Taylor, Stephen B Riggs, Jason Zhu, Earle F Burgess, Peter E Clark, Kris E Gaston, and James T Kearns Caroline D Lu*Caroline D Lu* More articles by this author , Oluwaseun AdeyemiOluwaseun Adeyemi More articles by this author , William E AndersonWilliam E Anderson More articles by this author , Timothy C HetheringtonTimothy C Hetherington More articles by this author , Yhenneko J TaylorYhenneko J Taylor More articles by this author , Stephen B RiggsStephen B Riggs More articles by this author , Jason ZhuJason Zhu More articles by this author , Earle F BurgessEarle F Burgess More articles by this author , Peter E ClarkPeter E Clark More articles by this author , Kris E GastonKris E Gaston More articles by this author , and James T KearnsJames T Kearns More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000920.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The USPSTF prostate cancer (PCa) screening guidelines have changed significantly in the past decade, from a recommendation against PSA-based screening in 2012 to a recommendation of shared decision-making for men age 55-69 in 2018. Most guidelines acknowledge that African American men should be screened more intensively than Caucasian men due to increased incidence of PCa and PCa mortality. Our objective was to characterize racial disparities in PSA screening and new PCa diagnoses in a large healthcare system with a diverse patient population to understand contemporary trends. METHODS: This retrospective cohort study used data from the Atrium Health Enterprise Data Warehouse, which includes patient clinical and demographic data from > 900 care locations across NC and SC. Participants included men ≥ 40 years seen in ambulatory/outpatient settings during 2014 - 2018. Exclusion criteria included prostate biopsy within 24 months or PCa diagnosis within 18 months prior to index encounter. PSA testing and PCa diagnoses were identified using laboratory data and ICD-9/ICD-10 codes, respectively. Age-standardized outcomes were reported for racial groups with > 2% population representation. Between-group comparisons were conducted using generalized estimating equations to account for within-subject correlation. RESULTS: Between 2014 - 2018, 582,846 men were seen in outpatient/ambulatory settings, including 416,843 Caucasians (71.5%) and 85,773 African Americans (14.7%). Screening rates declined among all age and racial groups. African American men were screened at a lower rate than Caucasian men (Figure 1). PCa diagnosis rate declined across all age groups, with largest declines in men aged ≥ 60. African American men had significantly higher rates of PCa diagnosis than Caucasian men each year (p<0.01). CONCLUSIONS: PSA screening and PCa diagnoses declined significantly between 2014-2018. African American men were less likely to be screened but more likely to be diagnosed with PCa than Caucasian men. Despite general consensus that African American men should be more intensively screened, significant racial disparities remain in PCa screening. Further study is warranted to understand patient, provider, and system factors that contribute to disparities in PCa care and outcomes. Source of Funding: N/A © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e816-e817 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Caroline D Lu* More articles by this author Oluwaseun Adeyemi More articles by this author William E Anderson More articles by this author Timothy C Hetherington More articles by this author Yhenneko J Taylor More articles by this author Stephen B Riggs More articles by this author Jason Zhu More articles by this author Earle F Burgess More articles by this author Peter E Clark More articles by this author Kris E Gaston More articles by this author James T Kearns More articles by this author Expand All Advertisement PDF downloadLoading ...