The Relationship Between Education and Prostate-Specific Antigen Testing Among Urban African American Medicare Beneficiaries

Abstract

Purpose We examined the association between socioeconomic status (SES) and prostate-specific antigen (PSA) cancer screening among older African American men. Methods We analyzed baseline data from a sample of 485 community-dwelling African American men who participated in the Cancer Prevention and Treatment Demonstration Trial. The outcome was receipt of PSA screening within the past year. SES was measured using income and educational attainment. Sequential multivariate logistic regression models were performed to study whether health care access, patient–provider relationship, and cancer fatalism mediated the relationship between SES and PSA screening. Results Higher educational attainment was significantly associated with higher odds of PSA screening in the past year (odds ratio (OR) 2.08 for college graduate compared to less than high school graduate, 95 % confidence interval (CI) 1.03–4.24); income was not. Health care access and patient–provider communication did not alter the relationship between education and screening; however, beliefs regarding cancer fatalism partially mediated the observed relationship. Conclusion Rates of prostate cancer screening among African American men vary by level of educational attainment; beliefs concerning cancer fatalism help explain this gradient. Understanding the determinants of cancer fatalism is a critical next step in building interventions that seek to ensure equitable access to prostate cancer screening.

The effect of socioeconomic status, race, and insurance type on newly diagnosed metastatic prostate cancer in the United States (2004–2013)

“…Additionally, compared to white men, black men may be less informed about PCa and screening and have a more fatalistic understanding of diagnosis. That is, they are more likely to believe that a diagnosis of PCa always implies an imminent PCa death [20,21]. Efforts to improve knowledge regarding screening and reduce these beliefs among minorities may improve screening practices and therefore early detection among these groups.…”

Mortality Among Men Bearing Prostate Cancer and its Association With Sociodemographic and Clinical Variables / Mortalidade em Homens com Câncer de Próstata e sua Associação com Variáveis Sociodemográficas e Clínicas

“…23 Low level of education in patients with PC is a common finding in profile studies, 17,18 when inferior to full secondary education and associated with intermediate risk tumors 24 are factors that increase the chance of mortality, including other causes. The higher level of schooling favors the PSA test, 25 which may aid in early detection and follow-up. In the present study, of the patients who died of PC, more than half had not completed the first degree.…”

Preparo De Medicamentos Endovenosos Para Adultos Hospitaizados: Desempenho Dos Profissionais De Enfermagem

“…Há autores que correlacionam a falta de conhecimento sobre os fatores de risco, entendimento da patologia e medidas preventivas aos baixos níveis de escolaridade encontrados na população estudada. Os profissionais de saúde devem estar atentos ao grau de escolaridade dos pacientes, para que a linguagem seja adaptada, no intuito de facilitar a compreensão das questões de saúde durante as consultas (HARARAH et al, 2015;SALEH et al, 2015).…”