Abstract C114: Prostate-specific antigen (PSA) screening practices before and after the U.S. Preventive Services Task Force (USPSTF) 2012 Recommendations: A focus on foreign-born men

Abstract

Background: Prostate cancer (PC) is the most frequently diagnosed cancer and a leading cause of mortality among men worldwide. There is evidence of a relationship between nativity and prostate cancer incidence; and, by 2050, one in five Americans living in the U.S. will be an immigrant. Little is known about the uptake of PSA screening for U.S.-based foreign-born men. Moreover, it is unclear if the prevalence of PSA screening changed within this population after the U.S. Preventive Services Task Force (USPSTF) 2012 recommendations against routine PSA screening. Objectives: Our objectives were to: 1) describe the factors associated with PSA screening prevalence for U.S.-based foreign-born men and 2) compare PSA screening prevalence before and after the USPSTF 2012 PSA screening recommendation for these men. Methods: Data were from the 2010 and 2015 National Health Interview Surveys and limited to men ages 40 years and older who responded to the question “Ever had a PSA test?”. Data were further limited to men who indicated that they were not born in the U.S. 50 states or the District of Columbia and were living in the U.S for five years or more. Multivariable logistic regression was used to examine determinants of PSA screening and to compare screening prevalence in 2010 and 2015. Results: The sample included 2,735 foreign-born men with the largest ethnic group being those who identify as Hispanic (46%). The final multivariable model included race/ethnicity, age, education, marital status, insurance status, survey year, and length of time living in the U.S. Asian men were less likely than non-Hispanic white men to report ever having had a PSA test (Odds Ratio (OR)=0.47, 95% Confidence Interval (CI) [0.36 – 0.61]). In addition, men who were widowed had lower odds than men who were married or living with a partner of ever having had a PSA test (OR=0.65, 95% CI [0.47 – 89]). Moreover, when compared to men who reported having a first degree relative with prostate cancer, men with unknown family history of prostate cancer had lower odds of ever having had a PSA test (OR=0.54, 95% CI [0.32 – 91]). Overall, men surveyed in 2015 were less likely to report ever having had a PSA test than those in 2010 (OR=0.76, 95% CI [0.63 – 0.92]). Conclusion: Among foreign-born men, lower odds of PSA screening prevalence was reported by men who were Asian, widowed and those with unknown family history of prostate cancer. Moreover, the USPSTF 2012 PSA recommendations against routine PSA screening appeared to lower PSA screening behaviors for these men several years later. These results can inform the development of prostate cancer interventions for this underserved group. Citation Format: Jarrett A. Johnson, Richard Moser, Gary Ellison, Damali Martin. Prostate-specific antigen (PSA) screening practices before and after the U.S. Preventive Services Task Force (USPSTF) 2012 Recommendations: A focus on foreign-born men [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C114.