(1) Identify the proportion of primary care visits in which American Indian/Alaska Native (AI/AN) men receive a prostate-specific antigen test (PSAT)and/or a digital rectal exam (DRE), (2) describe characteristics of primary care visits in which AI/AN receive PSA and/or DRE, and (3) identify whether AI/AN receive PSA and/or DRE less often than non-Hispanic White (nHW) men.
This was a secondary analysis of the National Ambulatory Medical Care Survey (NAMCS) during 2013-2016 and 2018 and the NAMCS Community Health Center (CHC) datasets from 2012-2015. Weighted bivariate and multivariable tests analyzed the data to account for the complex survey design.
For AI/AN men, 1.67 per 100 visits (95% CI = 0-4.24) included a PSATs (or PSAT) and 0 visits included a DRE between 2013-2016 and 2018. The rate of PSA for non-AI/AN men was 9.35 per 100 visits (95% CI = 7.78-10.91) and 2.52 per 100 visits (95% CI = 1.61-3.42) for DRE. AI/AN men were significantly less likely to receive a PSA than nHW men (aOR = 0.09, 95% CI = 0.01-0.83). In CHCs, AI/AN men experienced 4.26 PSAT per 100 visits (95% CI = 0.96-7.57) compared to 5.00 PSAT per 100 visits (95% CI = 4.40-5.68) for non-AI/AN men. DRE rates for AI/AN men was 0.63 per 100 visits (95% CI = 0-1.61) compared to 1.05 per 100 (95% CI = 0.74-1.37) for non-AI/AN men. There was not a statistically significant disparity in the CHC data regarding PSA (OR = 0.91, 95% CI = 0.42-1.98) or DRE (OR = 0.75, 95% CI = 0.15-3.74), compared to nHW men.
Efforts are needed to better understand why providers may not use PSA and DRE with AI/AN men compared to nHW men.
Cancer causes & control : CCC. 2023 May 23 [Epub ahead of print]
Chris Gillette, Tony Locklear, Ronny Bell, Nathan Bates, Jan Ostermann, Daniel Reuland, Kristie Foley, Cheyenne Lashmit, Sonia Crandall
Department of PA Studies, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA. ., Department of Public Health Education, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, USA., Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC, USA., Department of PA Studies, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA., Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA., Department of General Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA., Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA., High Point Family Practice, Atrium Health Wake Forest Baptist, High Point, NC, USA.