American Indian and Alaska Native men are less likely to get prostate cancer screening, including prostate-specific antigen (PSA) testing and digital rectal exams (DREs), compared to non-Hispanic White men, according to a Cancer Causes & Control study.
For this study, Dr. Chris Gillete and Colleagues looked at data from the National Ambulatory Medical Care Survey (NAMCS) over a period of five years (2013-2018). The researchers analyzed more than 5 million visits, of which 232988 were of American Indian/Alaska Native men. They collected more data from the NAMCS Community Health Center (CHC) datasets from 2012 to 2015. This brought the total number of visits analyzed for this study to more than 38 million, of which 320189 were American Indian/Alaska Native men.
From the data analyzed, the researchers observed statistical significance in rates of PSA testing and DREs among American Indian/Alaska Native men compared with non-Hispanic White men. Specifically, they observed that only 1.67 out of every 100 visits to a doctor by an American Indian/Alaska Native were PSA tests, compared with 9.35 out of every 100 visits by White men.
Furthermore, the researchers observed that over the same period, 0 of every 100 visits to a doctor by an American Indian/Alaska Native included DREs, compared with 2.52 out of every 100 visits by White men.
However, Dr. Gillette noted that these disparities may not exist when men visit community health centers. When they looked at the CHC datasets, they found that 4.26 out of every 100 visits to a doctor by an American Indian/Alaska Native were PSA tests, compared with 5.00 out of every 100 visits by White men. Similarly, DREs included 0.63 of every 100 visits to a doctor by an American Indian/Alaska Native included DREs, compared with 1.05 out of every 100 visits by White men. These results show that the differences in visits to CHC between American Indians/Alaska Natives and Europeans were not significant.
“More research is needed to better understand why,” Dr. Gillette said.
“Additional research is needed to explore how providers discuss PSA and DRE with this population, why there are differences in screening practices, and to examine access to care,” he added.
The researchers also noted that American Indian and Alaska Native men experience disproportionately greater prostate cancer mortality than other racial/ethnic identities. According to Dr. Gillette, this may be because when they present for care, their prostate cancer is more advanced compared to other racial/ethnic groups, which may directly result from the poor screening rate seen in American Indian and Alaska Native men.
Source: Urology Times
Journal Sources: CANCER CAUSES & CONTROL.