Prostate cancer screening practices of African-American and non-African-American US primary care physicians: a cross-sectional survey

Thomas B Richards,¹ Sun Hee Rim,¹ Ingrid J Hall,¹ Lisa C Richardson,¹ Louie E Ross<sup>2

1</sup>Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA; ²North Carolina A and T State University, Greensboro, NC, USA

Purpose: We explored whether African-American (AA) primary care physicians (PCPs) have different prostate cancer screening practices compared to non-AA PCPs, after adjustment for potential confounding factors such as the proportion of AA patients in PCP practices.
Methods: We used SAS/SUDAAN to compare weighted responses from AA PCPs (n = 604) with those from non-AA PCPs (n = 647) in the 2007–2008 National Survey of Primary Care Physician Practices Regarding Prostate Cancer Screening. We used multivariate logistic regression to calculate the weighted odds ratios (OR) and 95% confidence intervals (CI).
Results: We found that AA PCPs had higher odds of working in practices with above-the-median (≥21%) proportions of AA male patients (OR, 9.02; 95% CI: 5.85–13.91). A higher proportion of AA PCPs (53.5%; 95% CI: 49.5–57.4) reported an above-the-median proportion (≥91%) of PSA testing during health maintenance exams as compared to non-AA PCPs (39.4%; 95% CI: 35.5–43.4; P < 0.0002). After adjusting for the proportion of AA patients and other factors, we found that AA PCPs had higher odds of using PSA tests to screen men (OR, 1.74; 95% CI: 1.11–2.73).
Conclusion: This study quantifies the magnitude of the differences reported in previous focus group studies. Our results may be helpful in hypothesis generation and in planning future research studies.

Keywords: African-American, physician practice patterns, prostate-specific antigen, screening tests