Preventive Medical Services Research Articles

National Trends in PSA Cancer Screening With Parallel Investigation of Colorectal Cancer Screening: An Analysis of the CDC Behavioral Risk Factor Surveillance System From 2012 to 2022

Introduction/BackgroundFrom 2012 to 2022 there have been numerous revisions in the United States Preventative Task Force guidelines for prostate cancer screening, including advising against PSA testing to allowing shared-decision making for men aged 55 to 69. We sought to observe trends in PSA testing rates in relation to the changing guidelines. Conversely, colorectal cancer screening recommendations remained consistent for patients aged 50-75 and we sought to use this as a comparison to observe the effect of differing guidelines. MethodsThe Centers for Disease Control Behavioral Risk Factor Surveillance System is a national database of surveys on health-related behaviors and preventive medical services. We extracted responses from 2012 to 2022 regarding both prostate and colorectal cancer screening. Our primary variable of interest was prostate cancer screening while colorectal cancer screening served as a positive control. ResultsProstate cancer screening decreased among respondents from 70.1% in 2012 to 59.7% in 2022. However, there was a significant rebound in prostate cancer screening prevalence in 2022. In contrast, colorectal cancer screening rates steadily increased from 70.7% in 2012 to 78% in 2022. The annual percentage of men who had received prostate cancer screening was statistically different year to year. ConclusionsTrends in the rate of screening for prostate and colorectal cancer appeared to adapt to the updated recommendations. However, further investigation regarding lower income levels, minority groups, and uninsured men are essential to address the social and racial disparities seen in prostate cancer screening. Efforts to promote shared-decision making may improve effective cancer screening.

Zero-shot learning to extract assessment criteria and medical services from the preventive healthcare guidelines using large language models.

The integration of these preventive guidelines with Electronic Health Records (EHRs) systems, coupled with the generation of personalized preventive care recommendations, holds significant potential for improving healthcare outcomes. Our study investigates the feasibility of using Large Language Models (LLMs) to automate the assessment criteria and risk factors from the guidelines for future analysis against medical records in EHR. We annotated the criteria, risk factors, and preventive medical services described in the adult guidelines published by United States Preventive Services Taskforce and evaluated 3 state-of-the-art LLMs on extracting information in these categories from the guidelines automatically. We included 24 guidelines in this study. The LLMs can automate the extraction of all criteria, risk factors, and medical services from 9 guidelines. All 3 LLMs perform well on extracting information regarding the demographic criteria or risk factors. Some LLMs perform better on extracting the social determinants of health, family history, and preventive counseling services than the others. While LLMs demonstrate the capability to handle lengthy preventive care guidelines, several challenges persist, including constraints related to the maximum length of input tokens and the tendency to generate content rather than adhering strictly to the original input. Moreover, the utilization of LLMs in real-world clinical settings necessitates careful ethical consideration. It is imperative that healthcare professionals meticulously validate the extracted information to mitigate biases, ensure completeness, and maintain accuracy. We developed a data structure to store the annotated preventive guidelines and make it publicly available. Employing state-of-the-art LLMs to extract preventive care criteria, risk factors, and preventive care services paves the way for the future integration of these guidelines into the EHR.

Informing implementation and dissemination of a specialized primary care medical home for patients with serious mental illness: Clinician and administrator perspectives.

People with serious mental illness (SMI) have lower rates of use of preventative medical services and higher rates of mortality compared to the general population. Research shows that specialized primary care medical homes improve the health care of patients with SMI and are feasible to implement, safe, and more effective than usual care. However, specialized medical homes remain uncommon and model dissemination limited. As part of a controlled trial assessing an SMI-specialized medical home, we examined clinician and administrator perspectives regarding specialized versus mainstream primary care and identified ways to enhance the scale-up of a specialized primary care model for future dissemination. We conducted semistructured interviews with clinicians and administrators at three sites prior to the implementation of an SMI-specialized primary care medical home (n = 26) and at 1-year follow-up (n = 24); one site implemented the intervention, and two sites served as controls. Interviews captured service design features that affected the quality of care provided; contextual factors that supported or impeded medical home implementation; and knowledge, attitudes, and behaviors regarding the care of patients with SMI. Interviews were transcribed and coded. Clinicians and administrators described SMI-specialized primary care medical homes as advancing care coordination and outcomes for patients with SMI. Stakeholders identified elements of a specialized medical home that they viewed as superior to usual care, including having a holistic picture of patients' needs and greater care coordination. However, to enable scale-up, efforts are needed to increase staffing on care teams, develop robust clinician onboarding or training, and ensure close coordination with mental health care providers. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The use of complementary and alternative medicine for functional gastrointestinal disorders among the saudi population

Background and objectiveComplementary and alternative medicine (CAM) is a common practice among patients, who experience functional gastrointestinal disorders (FGID). Among the Saudi population, less is known about CAM use for FGID. Therefore, this study aimed to determine the prevalence of CAM utilization for FGID amongst the Saudi population and determine the types of CAM used for treatment. MethodA cross-sectional study was carried out in Riyadh, Saudi Arabia during February 2023 through social media platforms using questionnaires adopted from the literature. There were three sections in the questionnaire including demographic information, questions to determine the prevalence of CAM use for FGID, the types of FGID, and the types of CAM utilization, and questions on the sources of information about CAM. Multivariable logistic regression was applied to find factors associated with CAM use. All statistical analyses were performed using SPSS version 26. ResultsA total of 828 people participated in this study. The overall prevalence of CAM use for FGID problems was 87.2 %. There were no significant differences in CAM use for FGID problems between men (87.5 %) and women (86.3 %) (P = 0.727). The most commonly used types of CAM for FGID were ginger (73.4 %), chamomile (66.6 %), mint (61.6 %), turmeric (59.0 %), anise (55.5 %), fennel (43.1 %), and Activia yogurt©️ (42.7 %). The most common FGID disorders for utilizing CAM were IBS (29.9 %), followed by constipation (29.8 %), dyspepsia (22.7 %), and bloating (17.0 %). In the multivariable regression, age, gender and employment status did not have an impact on the odds of using CAM. The subjects who had high school, university, and postgraduate education had significant odds ratios of CAM use (OR = 2.73; 95 % CI: 1.22–6.13), (OR = 4.18; 95 % CI: 2.03–8.58), and (OR = 20.85; 95 % CI: 5.51–78.80), respectively, compared to subjects who did not complete high school. Participants who had private insurance had a significant odds ratio (OR = 0.27; 95 % CI: 0.14–0.55) compared to governmental insurance. ConclusionThe use of CAM among the Saudi population is alarmingly high; however, the lack of standardized medical recommendations and treatment options may be the cause. Although there were no significant gender differences, participants with higher educational levels and private insurance coverage were more likely to use CAM for FGID. Patients suffering from FGID and limited access to medical advice and treatment options are vulnerable to being exposed to dubious and incredible information sources. Expanding access to preventative medical services, funding governmental medical websites to provide credible information, educating healthcare professionals about FGID, and conducting more research in safe and effective treatments for FGID is recommended.

Pre-Pandemic and Recent Oral and Medical Health Care Utilization among Young American Indian Children and Their Caregivers

Children from diverse ethnic groups are at significantly increased risk for dental caries. In particular, American Indian (AI) children have the highest incidence of detal caries of any ethnic group. The COVID-19 pandemic dramatically restricted health care access, including preventive oral health care. Given this context, it is unclear whether or not preventive oral health care for AI children has resumed since lockdown. To address this question, we surveyed adult AI caregivers (N = 152) of children aged 0–5 years, assessing recent (12-month) and pre-COVID (for caregivers of children aged 3–5 years) preventive oral and medical health services. We also examined medical health care access and utilization among caregivers. Among children aged 3–5 years old, both pre-pandemic and past year medical care utilization were generally high (80 and 90%, respectively) as was any oral health care utilization (64 & 78%, respectively). Oral health check-ups were more common over the last year (62%) compared to pre-COVID (44%). Recent health care utilization among children 1–5 years old in this sample were generally comparable to national estimates, except for higher reported preventive medical care (99% vs. 87.6%, respectively) and higher preventive oral care (96% vs. 59.6%, respectively). More caregivers reported delaying or foregoing needed health care due to COVID (28–38%) versus due to cost (8–17%). In this survey of AI caregivers, recent child preventive health care utilization was high, and changes in utilization following the lockdown phases of the pandemic were comparable for oral and medical health care.

Make your choice: Angiography or periodical health examination?

Periodical health examination is one of the important factors influencing a healthy lifestyle. Patients undergoing routine physical examination in primary care are included in the scope of preventive medical services, which is the most basic principle of primary care. Identifying the risk factors enables individuals to adopt healthier lifestyle practices. In our study, we examined the correlation between patients undergoing coronary angiography for suspected coronary stenosis and the extent of primary care services they had received in their medical history, along with the severity of stenosis observed during the angiography. Patients were interviewed using a pre-structured questionnaire to gather information about their past utilization of primary healthcare services related to coronary matters and their cardiovascular (CV) risk profile as documented in their medical history. The necessary standard tests for angiography procedures were retrieved from patient records. The SYNTAX score, a tool that aids in the objective assessment of the severity of coronary artery disease (CAD), was computed and documented. This score was then compared with the history of primary care utilization. The patients' utilization of services from the Primary Healthcare Center (PHC) was evaluated using a scoring system, with an average score of 29.27 ± 11.27 out of 100 points (minimum: 20; maximum: 60). The average SCORE Türkiye indicating the 10-year risk of CV events for all patients was calculated as 14.31% ± 8.65% (high-very high risk), while the average SYNTAX score was 15.20 ± 9.97. There was a positive and significant correlation found between fasting blood glucose and creatinine values with both SYNTAX score and SCORE Türkiye (respectively; R = 0.238, P = .013; R = 0.289, P = .002). Factors such as smoking and metabolic syndrome were associated with CAD severity. It important to highlight that individual recommended for angiography had a notably lower utilization of healthcare services from the PHC based on their medical histories. This circumstance has resulted in individuals who do not undergo CV event screenings at PHCs having higher SYNTAX scores, indicating more severe CAD that necessitates angiography. Conducting regular periodical health examinations at PHCs can help mitigate these statistics.

A Roadmap to Integrating Dermatologic Care at a Student-Run Free Health Clinic

Student-run free health clinics (SRFCs) play an important role in providing a safety net healthcare system for uninsured patients by offering primary healthcare or preventative medical services. Patients at free clinics may have to be referred out for medical complaints better managed with specialty care. Integrating these services at SRFCs can address barriers to accessing specialty care. Free dermatologic care offers an opportunity to provide care to patients who may otherwise ignore symptoms, which can lead to reduced quality of life and a worse prognosis in some conditions. We detail a roadmap to integrate dermatologic services at an SRFC by providing operational considerations such as assessing needs, developing a clinical workflow, engaging dermatologists and the community, and sustaining student involvement. We also discuss the potential for a dermatology clinic to foster interest in the specialty among students underrepresented in medicine, given the current call to action to increase racial and ethnic diversity in the dermatologic workforce.

The impact of COVID-19 on patients diagnosed with melanoma, breast, and colorectal cancer

BackgroundThe COVID-19 pandemic impacted healthcare resource allocation and utilization of preventative medical services. It is unknown if there is resultant stage migration of melanoma, breast, and colorectal cancer when comparing extended time periods before and after the pandemic onset. MethodsA retrospective cohort study of melanoma, breast, and colorectal cancer patients was completed. Clinical and pathological staging was compared utilizing 12 and 22-month timeframes before and after the pandemic outbreak. ResultsBetween the 22-month pre- and post-COVID-19 groups, breast cancer clinical stage T2 significantly increased, and pathological stage 2 decreased. Colorectal cancer clinical stage T1 decreased, stage T4 increased, and stage 0 decreased in the 22-month groups. In the 12-month groups, melanoma clinical stage T1 increased, and colorectal cancer clinical stage N2 increased. ConclusionsEvaluating extended timeframes beyond the immediate pre- and post-COVID-19 period revealed significant increases in clinical staging of breast and colorectal cancer, suggesting advanced disease is becoming more evident as time progresses.

Diphtheria in Europe

A rising number of diphtheria cases were recorded in Europe in 2022, including in Belgium, within the newly arriving young migrant population. In October 2022, Médecins Sans Frontières (MSF) opened a temporary roadside container-clinic offering free medical consultations. Over 3 months of activity, the temporary clinic detected 147 suspected cases of cutaneous diphtheria with 8 laboratory-confirmed cases growing toxigenic Corynebacterium diphtheriae. This was followed by a mobile vaccination campaign, during which 433 individuals living rough in squats and informal shelters were vaccinated. This intervention has shown how even in Europe’s capital, access to preventive and curative medical services remains difficult for those who need it the most. Appropriate access to health services, including routine vaccination, are crucial to improve the health status among migrants.

Study on the Criteria for Priority-Setting and Application in Expanding Health Insurance Benefit of Preventive Medical Service: The Case of Obesity

Study on the Criteria for Priority-Setting and Application in Expanding Health Insurance Benefit of Preventive Medical Service: The Case of Obesity

TOOLKIT FOR PROMOTING THE SYSTEMIC DEVELOPMENT OF HEALTH CARE INSTITUTIONS AT THE LOCAL LEVEL

In the study, attention is updated to the problem of stimulating the development of small entrepreneurship at the local level and simultaneously improving the system of providing social services to the local population, in particular medical care. It was emphasized that stimulating the development of small business entities and also the medical sector in rural and remote areas is a very difficult task that requires identification in the implementation of specific tools and the involvement of sufficient resources for such purposes. It has been proven that this is why research in this field is always unique and has a high theoretical, methodological and applied value. The purpose of the study is to improve the theoretical, methodological and applied principles of forming policy tools for supporting and stimulating the development of small entrepreneurship in the medical field at the local level. It is shown that the decentralization reform, which is being implemented with permanent success in Ukraine, has largely shifted from the central to the local level the issue of management and financial and resource provision of local social and economic development. These issues become particularly acute in the field of medicine, and often local self-government bodies are objectively unable to solve these extremely difficult tasks on their own. It is necessary to use non-traditional methods and approaches. One of these can be the stimulation of private business in the form of small private health care institutions that provide a wide range of diagnostic and preventive medical services to the population. It was concluded that the policy of local self-government bodies in terms of promoting the development of small business initiatives in the field of providing medical services to the population should be broad in nature, in particular aimed at the general socio-economic development of small towns and surrounding rural areas. Conceptually, the principles of such a policy can be implemented in the following directions: development of production factors; creation and improvement of small business support infrastructure; formation of solvent demand due to increased employment and incomes of the population; development of priority sectors of the economy; increasing the efficiency of small enterprises in the medical field.

Impact of lower co-payments on risk-reducing salpingo-oophorectomy and BRCA testing in Japan

BackgroundIn April 2020, insurance coverage for risk-reducing salpingo-oophorectomy (RRSO) for breast cancer patients with hereditary breast and ovarian cancer (HBOC) syndrome and BRCA testing were started in Japan. We investigated the impact of insurance coverage on the number of RRSO and BRCA tests performed.MethodsThe subjects were 370 breast cancer patients and 23 of their relatives who received genetic counseling at our institution between April 2014 and December 2021. Finally, 349 patients and 15 relatives were analyzed. We retrospectively compared the number of BRCA tests, RRSO, insurance status, and co-payment of medical expenses before and after insurance coverage based on medical records.ResultsIn the 6-year pre-coverage period, 226 patients (mean: 37/year) received genetic counseling and 106 (17/year) received BRCA testing. In the 21-month post-coverage period, 161 patients (92/year) received genetic counseling and 127 (72/year) received BRCA testing. The rate of testing/counseling significantly increased in the post-coverage period (46.9% vs. 78.8%; p < .001). The number of patients who were diagnosed with HBOC were 24 (4/year) and 18 (10/year) and RRSO was performed for 7 (1/year) and 11 (6/year) patients in the pre- and post-coverage periods, respectively. The rate of RRSO/HBOC was significantly increased in the post-coverage period (29.1% vs. 61.1%; p = 0.039). RRSO patients' co-payment rates decreased from 64% to 25% pre- and post-coverage.ConclusionsOur findings suggest that decreased co-payments were the primary reason for these increases. Insurance coverage is an important factor when promoting preventive medical services such as RRSO.

Factors Associated with Lack of Health Screening among People with Disabilities Using Andersen’s Behavioral Model

People with disabilities often have poorer health than the general population, and many do not participate in preventive care. This study aimed to identify the health screening participation rates of such individuals and investigate why they did not receive preventive medical services based on Andersen's behavioral model, using data from the Survey on Handicapped Persons with Disabilities. The non-participation health screening rate for people with disabilities was 69.1%. Many did not in health screening because they showed no symptoms and were considered healthy, in addition to poor transportation service and economic limitations. The binary logistic regression result indicates that younger age, lower level education, and unmarried as predisposing characteristics; non-economic activity as the enabling resources; and no chronic diseases, severe disability grade, and suicidal ideation as need factor variables were the strongest determinants of non-participation health screening. This indicates that health screening of people with disabilities should be promoted while takings into account the large individual differences in socioeconomic status and disability characteristics. It is particularly necessary to prioritize ways to adjust need factors such as chronic disease and mental health management, rather than focusing on uncontrollable predisposing characteristics and enabling resources among barriers to participation in health screening for people with disabilities.

A lightweight blockchain and fog-enabled secure remote patient monitoring system

IoT has enabled the rapid growth of smart remote healthcare applications. These IoT-based remote healthcare applications deliver fast and preventive medical services to patients at risk or with chronic diseases. However, ensuring data security and patient privacy while exchanging sensitive medical data among medical IoT devices is still a significant concern in remote healthcare applications. Altered or corrupted medical data may cause wrong treatment and create grave health issues for patients. Moreover, current remote medical applications’ efficiency and response time need to be addressed and improved. Considering the need for secure and efficient patient care, this paper proposes a lightweight Blockchain-based and Fog-enabled remote patient monitoring system that provides a high level of security and efficient response time. Simulation results and security analysis show that the proposed lightweight blockchain architecture fits the resource-constrained IoT devices well and is secure against attacks. Moreover, the augmentation of Fog computing improved the responsiveness of the remote patient monitoring system by 40%.

Респираторно-синцитиальная инфекция – современное состояние проблемы

The review shows the main current data concerning the etiology, epidemiology, pathogenesis, features of the clinical picture, diagnosis, treatment and prevention of respiratory syncytial virus (RSV). We studied the influence of respiratory syncytial virus (RSV) on the severity of the disease depending on age, concomitant pathology, genetic factors. Over the past decades, manifest forms of infection have become more frequent in the elderly, especially with weakened immunity with the development of severe forms of the disease with damage to the lower respiratory tract. During the systematization, the importance of epidemiological surveillance for RSV was determined. Data on the incidence of RSV on the territory of the subjects of Russian Federation with a high degree of probability cannot reflect the true picture, due to the lack of alertness of primary care doctors and specialists providing medical care in the inpatient departments. This is accompanied by the complexity of diagnostics and laboratory differential diagnosis with other respiratory infections. The problem is aggravated due to the lack of effective etiotropic therapy, as well as the availability of only passive immunization for children under two years of age from the means of specific prevention. Thus, these aspects raise a number of important issues for epidemiological and medical-preventive services. Keywords: bronchiolitis, pneumonia, respiratory syncytial infection, respiratory syncytial virus

Musculoskeletal Literacy in Orthopedics: Associated Factors, Effects on Patient-Physician Communication and Intervention Strategies.

Health literacy is defined as the degree to which an individual obtains and processes basic health information and services so as to make appropriate and informed health decisions. Limited health literacy (LHL), as assessed by various validated instruments, remains prevalent amongst older adult patients, non-Caucasian ethnicities, and those of lower socioeconomic backgrounds. Of concern, LHL has been associated with decreased medical knowledge, disuse of preventative medical services, worse chronic disease control and increased use of emergency services. Within orthopedics specifically, LHL has been associated with lower expectations regarding outcomes and ambulation following total hip and knee surgery and fewer questions asked regarding diagnosis and treatment in the outpatient care setting. In some cases, LHL has been independently correlated with worse patient-reported outcome measures (PROMs), though this finding may be due in part to the reading level required of the PROMs. There is growing evidence that active intervention by the orthopedic provider and demonstration of empathy improves patient comprehension of the nature of their musculoskeletal complaints, aids informed decision-making and, ultimately, maximizes patient satisfaction. Recognition of the associated factors for LHL will ensure improved physician-patient communication through the implementation of health literate interventions focused on those most at-risk.

The effects of the Affordable Care Act on seasonal agricultural workers

AbstractThis study investigates the effects of the Affordable Care Act (ACA) policies (Medicaid expansion, health insurance premium subsidy, and tax penalty) on farmworkers' health insurance coverage and healthcare utilization. Using the National Agricultural Worker Survey, we find that the ACA policies substantially raised the share of seasonal farmworkers with medical insurance. It significantly increased workers' use of preventive medical services and decreased the use of hospitals, including emergency rooms, which was a goal of the law's proponents. These effects did not significantly differ between workers with and without a pre‐existing medical condition.

Decreasing Peripheral Intravenous Catheter (PIV) Associated Methicillin-resistant Staphylococcus Aureus (MRSA) Bacteremia

<h3>Background</h3> A 210-bed community hospital experienced 13 MRSA bacteremia events from July 2017 - June 2019. Among those infections, 46.2% were associated with the use of a PIV. Review of MRSA bacteremia infections identified a lack of standardized prevention measures in patients with PIVs. <h3>Methods</h3> A multidisciplinary team was assembled consisting of Infection Prevention (IP), nursing, anesthesia, and Emergency Medical Services (EMS) to create and implement a PIV bundle. The bundle included labeling, dating, and assessing intact, clean dressings. Following bundle development, education was conducted across the hospital via skills fair with hands-on training and roving in-services to ensure 90% of affected staff were reached. IP collected pre-intervention data and bundle audit data weekly to monitor improvement. During audits, the IP performed just-in time education and feedback on bundle non-compliance. PIV-bacteremia prevention education was incorporated into orientation for new nurses. Additional education was conducted with Anesthesia and EMS providers on PIV insertion technique and infection prevention processes. <h3>Results</h3> Baseline compliance with PIV-bundle components was 13.6% and increased to 69.0% in December of 2019 when the project ended. Dressing cleanliness increased from 66.0% in the baseline period to 88.7% Current data in December 2021 indicates an overall PIV bundle compliance rate of 80.6% demonstrating sustainability in the intervention. PIV-associated MRSA bacteremia decreased from 1.04 infections/10,000 patient days to 0 infections/10,000 patient days (p = 0.008). <h3>Conclusions</h3> PIV-associated bacteremia can be a major contributor to overall MRSA bacteremia. A comprehensive PIV bundle with stakeholder engagement is an effective intervention to reduce MRSA-bacteremia. Improving PIV maintenance practices reduces MRSA bacteremia.

PD17-07 PSA TESTING AND COLORECTAL CANCER SCREENING TRENDS FROM 2012 TO 2020: ANALYSIS OF THE CDC BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS)

You have accessJournal of UrologyCME1 May 2022PD17-07 PSA TESTING AND COLORECTAL CANCER SCREENING TRENDS FROM 2012 TO 2020: ANALYSIS OF THE CDC BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) Anh Nguyen, John Fastenau, Gabriel Fernandez, Courtney Berg, Amjad Alwaal, Evan Kovac, and Robert Weiss Anh NguyenAnh Nguyen More articles by this author , John FastenauJohn Fastenau More articles by this author , Gabriel FernandezGabriel Fernandez More articles by this author , Courtney BergCourtney Berg More articles by this author , Amjad AlwaalAmjad Alwaal More articles by this author , Evan KovacEvan Kovac More articles by this author , and Robert WeissRobert Weiss More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002555.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In 2021 it is estimated that there will be 248,530 new cases of prostate cancer with 34,130 deaths, and 149,500 new cases of colorectal cases with 52,900 deaths. Before 2012, prostate specific antigen (PSA) screening was performed at a higher rate than colorectal cancer (CRC). The USPTF recommends colorectal screen for adults between the ages of 50-75, while it recommends shared decision-making regarding PSA testing for men between the ages of 55-69. We sought to compare PSA screening to CRC screening from 2012-2020. Data was stratified by income, geographic region, race and health insurance. METHODS: We used the CDC’s BRFSS, a national database of surveys on health-related behaviors and preventive medical services. We examined bi-yearly data on PSA testing for men aged 50+ and corresponding CRC screening data (colonoscopy and sigmoidoscopy). Income, geographic region, self-identified race, and health insurance status were examined. RESULTS: 367,535 men, aged 50+ responded if they had PSA testing and CRC screening and answered demographic questions from 2012-2020. PSA testing decreased from 73.0% of respondents in 2012 to 57.7% in 2020. CRC screening increased from 69.5% in 2012 to 75.1% in 2020. CRC screening was the most influential on adherence to PSA testing [OR]=4.69. Having health insurance was a positive predictor of PSA adherence [OR]=2.73 and CRC [OR]=3.18. Those with lower income were less likely to receive PSA testing [OR]=0.36 and CRC screening [OR]=0.31. PSA testing increased with age until 80 years and CRC screening increased until 75 years then both decreased. The Mid-Atlantic region had the highest adherence to PSA testing, whereas the North East region had the highest CRC screening. Non-Hispanic White and non-Hispanic Black men were most likely to have received a PSA test compared to other racial groups. CONCLUSIONS: PSA testing among men age 50+ has decreased from 2012 to 2020 while CRC screening has increased which reflects respective USPTF guidance. Men who underwent CRC screening were four times more likely to get PSA testing. Decreasing rates of PSA testing has implications in detection and severity of prostate cancer on diagnosis. Observed trends among lower income levels, minority groups, and uninsured men demonstrate disparities in PSA testing. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e338 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anh Nguyen More articles by this author John Fastenau More articles by this author Gabriel Fernandez More articles by this author Courtney Berg More articles by this author Amjad Alwaal More articles by this author Evan Kovac More articles by this author Robert Weiss More articles by this author Expand All Advertisement PDF DownloadLoading ...

Knowledge Mapping Analysis of Public Health Emergency Management Research Based on Web of Science.

At present, major public health emergencies frequently occur worldwide, and it is of great significance to analyze the research status and latest developments in this field to improve the ability of public health emergency management in various countries. This paper took 5,143 related studies from 2007 to 2020 from the Web of Science as research object and used CiteSpace, VOSviewer, and other software to perform co-word analysis, social network analysis, and cluster analysis. The results and conclusions were as follows: (1) the related research identified three periods: the exploration, growth, and outbreak period; (2) chronologically: the relevant research evolved from medical and health care for major diseases to emergency management and risk assessment of public health emergencies and then researched the novel coronavirus (COVID-19) pneumonia epidemic; (3) clustering analysis of high-frequency keywords, identifying three research hotspots: “disaster prevention and emergency medical services,” “outbreak and management of infectious diseases in Africa,” and “emergency management under the COVID-19 pneumonia epidemic.” Finally, this study combined the data and literature analysis to point out possible future research directions: from the research of the COVID-19 pneumonia epidemic to the research of general major public health emergencies, thinking and remodeling of the national public health emergency management system, and exploring the establishment of an efficient international emergency management cooperation mechanism.