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Racial Disparities in Prostate Cancer Screening: The Role of Shared Decision Making.

Nicola Frego1, Edoardo Beatrici1, Muhieddine Labban2

  • 1Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Urology, Humanitas Research Hospital - IRSSC, Milan, Italy.

American Journal of Preventive Medicine
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Summary
This summary is machine-generated.

Shared decision making may reduce racial disparities in prostate-specific antigen screening for men aged 55-69. This approach can help mitigate race-based differences in screening likelihood.

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Area of Science:

  • Urology
  • Preventive Medicine
  • Health Disparities Research

Background:

  • The 2018 U.S. Preventive Services Task Force guidelines recommend shared decision making for prostate-specific antigen (PSA) screening in men aged 55-69.
  • These guidelines also suggest considering patient race/ethnicity in PSA screening decisions.
  • Existing research highlights race-based disparities in PSA screening rates.

Purpose of the Study:

  • To investigate whether shared decision making (SDM) influences the association between race/ethnicity and the likelihood of undergoing PSA screening.
  • To assess if SDM acts as a moderator in race-based disparities in PSA screening.

Main Methods:

  • Cross-sectional analysis of men aged 55-69 from the 2020 U.S. Behavioral Risk Factor Surveillance System survey.
  • Complex sample multivariable logistic regression models were employed.
  • An interaction term between race/ethnicity and estimated shared decision making was used to test for moderation.

Main Results:

  • Estimated shared decision making significantly predicted PSA screening (AOR=2.65).
  • A significant interaction (p=0.001) was found between race/ethnicity and shared decision making.
  • Without SDM, non-Hispanic Black and Hispanic men were less likely to be screened than non-Hispanic White men.
  • With SDM, no significant race-based differences in screening were observed.

Conclusions:

  • Shared decision making may be a valuable strategy to reduce race-based disparities in prostate-specific antigen screening.
  • Further research on implementing SDM is needed to address screening inequities.
  • SDM has the potential to attenuate the impact of race/ethnicity on PSA screening likelihood.