PD58-12 PSA SCREENING AT THE INTERSECTION OF POLITICS AND POLICY

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality Improvement & Patient Safety I1 Apr 2017PD58-12 PSA SCREENING AT THE INTERSECTION OF POLITICS AND POLICY Jesse Sammon, Emily Serrel, Malte Vetterlein, Patrick Karabon, Gregory Mills, Moritz Hansen, Mani Menon, Quoc-Dien Trinh, and Firas Abdollah Jesse SammonJesse Sammon More articles by this author , Emily SerrelEmily Serrel More articles by this author , Malte VetterleinMalte Vetterlein More articles by this author , Patrick KarabonPatrick Karabon More articles by this author , Gregory MillsGregory Mills More articles by this author , Moritz HansenMoritz Hansen More articles by this author , Mani MenonMani Menon More articles by this author , Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author , and Firas AbdollahFiras Abdollah More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2627AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The implementation of health care policy in the U.S. may be impacted by conflicting political philosophies. A ″conservative″ view of health care emphasizes an individual′s right to self-determination, while a ″liberal″ view holds that government can effectively utilize strategies to balance the needs of the community with those of an individual. Federal screening guidelines promoting population health may be perceived to conflict with conservative values. The aim of this study was to assess the inter-relationship of a states percentage of ″conservative″ men and the impact that the 2012 USPSTF recommendation against PSA-based prostate cancer (PCa) screening on screening probability. METHODS Data from the 2012 and 2014 Behavioral Risk Factor Surveillance System was used to identify asymptomatic men (age ≥ 50) without PCa who reported PSA screening in the past 12 months. Odds ratios were determined by multivariate logistic regression analysis, adjusting for age, race, education, income, insurance, healthcare access, and marital status. The change in PSA screening rates were assessed as a function of the percentage of adults in a state describing themselves as ″conservative″ or ″very conservative″ in Gallup U.S. Daily (accessed 4/4/16). RESULTS Among 222,475 survey respondents, the prevalence of PSA screening decreased between 2012 and 2014 (OR=0.87, p<0.001; Fig 1a). In the most conservative states (upper tertile of self-described conservatives) screening prevalence was unchanged (OR=0.92, CI 0.84-1.00), and in the least conservative states (lowest tertile) there was a significant decline (OR=0.72, CI 0.64-0.81; Fig 1b).Up to 22% of the variation in PSA screening rates may be ascribed to a state′s dominant political leaning (coefficient of determination=0.22), a moderate and significant correlation (ρ= 0.47, P<0.001). CONCLUSIONS The changes in PSA screening rates appear to reflect the political divide in the U.S. Despite the 2012 USPSTF guideline and subsequent overall decrease in PSA screening, there was no decline in PSA screening in the most conservative states. This is a hypothesis-generating finding, as it is predicated on observational data that may be affected by other factors. Nonetheless, this finding suggests that a state′s dominant political ideology influences the implementation of federal health care screening policy. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1132 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Jesse Sammon More articles by this author Emily Serrel More articles by this author Malte Vetterlein More articles by this author Patrick Karabon More articles by this author Gregory Mills More articles by this author Moritz Hansen More articles by this author Mani Menon More articles by this author Quoc-Dien Trinh More articles by this author Firas Abdollah More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...