Racial differences in prostate cancer screening by family history

Prostate cancer (CaP) is disproportionately prevalent among black, compared to white, men. Additionally, men with a family history of CaP have 75% to 80% higher risk of CaP. Therefore we examined racial variation in the association of family history of CaP and self-reported prostate-specific antigen (PSA) testing in the nationally-representative National Health Interview Survey (NHIS).

Data were obtained from the 2005 NHIS, including the Cancer Control Module supplement. We restricted the study sample to men over the age of 40 who reported having "ever heard of a PSA test" (N = 1,744). Men were considered to have a positive family history if either their biological father or at least one biological brother had been diagnosed with CaP. SUDAAN 9.0 was used to perform descriptive and multivariable logistic regression analyses.

Men with a family history of CaP were more likely to have a PSA test than those who never had a PSA test (odds ratio [OR] = 1.8; 95% confidence interval [CI]: 1.3-2.5). Among blacks, men with a family history were not significantly more likely to have a PSA test.

Despite having the highest risk of cancer, black men with a family history are not screened more than black men without a family history.