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Zurl, H; Dagnino, F; Shabo, M; Mahmood, R; Allar, BG; Gershman, B; Weissman, L; Ortega, G; Hastings, S; Rayala, HJ.
Prostate Cancer Screening Among Traditionally Underserved Populations at a Large Public Safety-Net Institution
J GEN INTERN MED. 2025; Doi: 10.1007/s11606-025-09502-w
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Abstract:
Background: Existing literature underscores racial and sociodemographic disparities in prostate cancer screening (PCS) in the USA. Objective: To evaluate whether traditional PCS disparities are evident within a health safety-net institution tailored to support traditionally underserved populations. Design: A retrospective cohort study using electronic health-record data was conducted at an urban safety-net institution. Participants: Male patients aged 51-70 years with a primary care provider (PCP) visit from 2018 to 2019 were included. Main Measures: The primary outcome was PCS, defined as receiving a Prostate Specific Antigen (PSA) blood test within the study period. Investigated patient characteristics included self-reported race and ethnicity, language, insurance, marital status, median household income, serious mental illness (SMI), substance use disorder (SUD), and family history of prostate cancer (PCa). Bivariate analyses using chi-squared tests and multivariable logistic regression analyses were performed to compare PCS rates between the groups. Key Results: The cohort included 10,059 men, of which 40.4% had PCS. In total, 57.3% of the study population was of non-White race and 61.4% of non-North American/European ethnicity. A total of 31.2% had limited English proficiency (LEP), 17.8% had SMI, and 13.2% had SUD. In multivariable analysis of race, Black patients (OR 1.96, 95%CI 1.71-2.24, p < 0.001) and Hispanic patients (OR 1.51, 95%CI 1.3-1.76, p < 0.001) had significantly higher odds of PCS than White patients. Patients with LEP did not exhibit significantly lower screening rates than English-speaking patients (ORs 0.99-1.17). Conclusions: Within a healthcare institution designed and implemented to meet the needs of underserved populations, traditional racial and sociodemographic disparities in PCS are not evident.

Find related publications in this database (Keywords)
Prostate cancer screening
Sociodemographic factors
PSA
Race/ethnicity
Safety-net health system
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