患者和医生对黑人个人中前列腺特异性抗原测试的看法
Jenney R Lee1, Dante' Morehead1, Ben Young2
1Department of Urology, Center for Health Outcomes Research and Dissemination, University of Washington, Seattle.
JAMA network open
|September 8, 2025
概括
黑人男性面临更高的前列腺癌死亡率. 由于指导方针的局限性,初级保健提供者往往不优先考虑前列腺特异性抗原 (PSA) 测试,从而阻碍了这一高风险群体的早期检测.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 公共卫生 公共卫生
- 健康差异 在健康上的差异
背景情况:
- 在美国,黑人患前列腺癌的死亡率是黑人的两倍.
- 现有的指南缺乏针对高风险人群前列腺癌查的种族意识建议.
- 影响黑人男性前列腺癌查准入的结构因素需要检查.
研究的目的:
- 调查在美国黑人中促进或阻碍获得前列腺癌查的结构因素.
- 了解黑人男性和医疗保健提供者关于前列腺特异性抗原 (PSA) 测试的观点.
主要方法:
- 一项在六个西北州的临床和社区环境中进行的定性混合方法研究.
- 包括与29名黑人男性进行的半结构面试,这些黑人男性有前列腺癌的风险.
- 调查了31名初级保健医生 (PCP) 和32名泌尿科医生,了解他们对PSA检测的知识,态度和做法.
主要成果:
- 接受采访的人认为PCP是PSA测试的门卫,往往缺乏特定知识,对其使用持不利态度.
- 黑人男性报告说,他们缺乏与PCP的信任关系,以便在查中共同做出决定.
- 虽然了解指导方针,但PCP对PSA测试的早期检测和降低死亡率的价值比泌尿科医生少得多.
结论:
- PCP的看法和依赖目前的指导方针,这些指导方针排除了黑人男性等高风险群体,为前列腺癌查创造了障碍.
- 将基于证据的PSA查指南纳入现有指南可以显著改善早期检测.
- 解决提供者的知识,态度和指南限制对于减少前列腺癌差异至关重要.
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