title: Racial differences in prostate-specific antigen-based prostate cancer screening: State-by-state and region-by-region analyses.
abstract: Black men are more prone to harbor prostate cancer. They are more likely to succumb to this tumor than their White counterparts and may benefit from early detection and treatment. In this study, we assess the nationwide and regional disparity in prostate-specific antigen (PSA) screening for prostate cancer between Black men and non-Hispanic Whites (NHWs).
  
  
  
  A total of 247,079 (weighted 55,185,102) men, aged 40 to 99 years, who responded to the 2012 and 2014 behavioral risk factor surveillance system surveys were used for our analysis. End points consisted of self-reported PSA screening and self-reported nonrecommended PSA screening within 12 months of the interview. The latter was defined as screening in men with <10-year life expectancy. Available sociodemographic variables were used to predict these end points. The independent predictors from multivariate models were used to calculate the adjusted prevalence of PSA screening and nonrecommended PSA screening on a nationwide and regional level. These numbers were calculated for Blacks and NHWs separately and were compared between the 2 groups.
  
  
  
  Prevalence of PSA screening was 30.7% in NHWs vs. 28.1% in Blacks (P<0.001). On a region-based analysis, New England, Middle Atlantic, South Atlantic, East North Central, East South Central, West South Central, and Mountain showed a significantly higher rate of PSA screening in NHWs as compared to Blacks (all P<0.001). Middle Atlantic had a significantly higher prevalence of nonrecommended screening in NHWs as compared to Blacks, whereas South Atlantic, West South Central, and Pacific had a significantly higher prevalence of nonrecommended screening in Blacks as compared to NHWs (all P<0.001). Overall, 43 states performed screening more frequently to NHWs, whereas only 8 states performed it more frequently to Black men. The nonrecommended screening was performed more frequently to NHWs in 19 states, whereas 24 states performed it more frequently to Black men.
  
  
  
  Our study demonstrates that on a regional-level (and state-level), there are significant racial differences in overall and nonrecommended PSA screening across the United States. Further research is necessary to identify the reasons for the differences and help overcoming it.
authors.affiliation: Vattikuti Urology Institute, Vattikuti Urology Institute (VUI) Center for Outcomes Research Analytics and Evaluation, Henry Ford Hospital, Detroit, MI.
authors.forename: Tarun
authors.initials: T
authors.lastname: Jindal
authors.affiliation: Vattikuti Urology Institute, Vattikuti Urology Institute (VUI) Center for Outcomes Research Analytics and Evaluation, Henry Ford Hospital, Detroit, MI.
authors.forename: Naveen
authors.initials: N
authors.lastname: Kachroo
authors.affiliation: Vattikuti Urology Institute, Vattikuti Urology Institute (VUI) Center for Outcomes Research Analytics and Evaluation, Henry Ford Hospital, Detroit, MI; Division of Urology, Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, ME.
authors.forename: Jesse
authors.initials: J
authors.lastname: Sammon
authors.affiliation: Vattikuti Urology Institute, Vattikuti Urology Institute (VUI) Center for Outcomes Research Analytics and Evaluation, Henry Ford Hospital, Detroit, MI.
authors.forename: Deepansh
authors.initials: D
authors.lastname: Dalela
authors.affiliation: Vattikuti Urology Institute, Vattikuti Urology Institute (VUI) Center for Outcomes Research Analytics and Evaluation, Henry Ford Hospital, Detroit, MI.
authors.forename: Akshay
authors.initials: A
authors.lastname: Sood
authors.affiliation: Vattikuti Urology Institute, Vattikuti Urology Institute (VUI) Center for Outcomes Research Analytics and Evaluation, Henry Ford Hospital, Detroit, MI; Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Malte W
authors.initials: MW
authors.lastname: Vetterlein
authors.affiliation: Vattikuti Urology Institute, Vattikuti Urology Institute (VUI) Center for Outcomes Research Analytics and Evaluation, Henry Ford Hospital, Detroit, MI; Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI.
authors.forename: Patrick
authors.initials: P
authors.lastname: Karabon
authors.affiliation: Vattikuti Urology Institute, Vattikuti Urology Institute (VUI) Center for Outcomes Research Analytics and Evaluation, Henry Ford Hospital, Detroit, MI.
authors.forename: Wooju
authors.initials: W
authors.lastname: Jeong
authors.affiliation: Vattikuti Urology Institute, Vattikuti Urology Institute (VUI) Center for Outcomes Research Analytics and Evaluation, Henry Ford Hospital, Detroit, MI.
authors.forename: Mani
authors.initials: M
authors.lastname: Menon
authors.affiliation: Division of Urological Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
authors.forename: Quoc-Dien
authors.initials: QD
authors.lastname: Trinh
authors.affiliation: Vattikuti Urology Institute, Vattikuti Urology Institute (VUI) Center for Outcomes Research Analytics and Evaluation, Henry Ford Hospital, Detroit, MI. Electronic address: firas.abdollah@gmail.com.
authors.forename: Firas
authors.initials: F
authors.lastname: Abdollah
mesh_terms: D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000032:analysis / Q000378:metabolism*; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000378:metabolism; D044469:Racial Groups
chemical_list: D017430:Prostate-Specific Antigen
keywords: Prostate cancer; Prostate-specific antigen; Race; Screening; The United States